Idaho State University, Private Swim Lessons Intake Form
One-on-one instruction available for all ages and abilities.

Private instruction is based on instructor availability.

Private lessons are arranged between instructor and student and typically held during combo swim hours.

Please complete this form, and if an instructor is available, he or she will contact you.
Student Name *
Your answer
Parent/Guardian Name (if student is a child)
Your answer
Age of Participant (if adult, write ADULT) *
Your answer
Contact Phone *
Your answer
Contact Email *
Your answer
Preferred Contact Method *
Required
Type of Lesson Requested *
Level of Swimmer *
When are you available? What times and days do you prefer? *
Your answer
When would you like to start your lessons? *
MM
/
DD
/
YYYY
How often and for how long would you like to take private lessons? Do you want to meet once weekly, twice weekly, or more?
Your answer
Do you want to take regular lessons for an extended period of time, or are you looking for a few lessons?
Your answer
What is your goal? What do you wish to get from your swim lessons?
Your answer
Do you have a preference on instructor (requesting a specific person) or instructor gender? *
Would you like to receive information about our children's small group lessons?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service