District 6 Swimming and Diving Entry Fees Form


School Name _____________________________________________________


Number of Athletes Competing ________

                 x $7/athlete                      x$7


Total Amount Paid                     ________

Note:  Minimum of $25/school.


Coach’s Name ___________________________________________________


Coach’s Contact Phone Number _____________________________________


Checks should be made payable to “PIAA District VI” and mailed by Feb. 23, 2013 to:

            Susan Werner, District VI Swimming and Diving Chairperson

            1324 Appletree Circle

            State College, PA 16803