This information is required from current Chapman University student athletes and will be used by the Office of Sports Information for team rosters, press releases, media guides and various publicity functions of the university and the Department of Intercollegiate Athletics. We appreciate your help in filling out this form completely and in as much detail as possible.

First Name

 Last Name
Preferred Name
(for rosters/media)		    
Please select which
sport(s) you play at
Chapman		  
Eligibility Year
(Fr., So., Jr., Sr.)		 Position
Height Weight
Birthdate/Age Major
Permanent Address Minor
Home Phone Cell Phone
Email "Home" Town
High School Year Graduated

High School Varsity Sports Played:
School Sport Years Position(s)
Example High Soccer 2007-09 DEF, GK

Junior College Sports Played:
School Sport Years Position(s)
Example JC Soccer 2009 GK

Other Four-Year College Sports Played:
School Sport Years Position(s)
Example Univ. Soccer 2010 GK

ATHLETIC Honors & Awards - For each sport you've played list the honors and awards you've received, by year (varsity only). Include team, league, regional and national awards, along with outstanding statistics or team records.

High School

College

ACADEMIC Honors & Awards - Please list any awards based on academic achievement (can be combined with athletic achievement, i.e. Scholar Athlete). Include Who's Who, honor societies, Dean's Lists, scholarships, etc.

High School

College

IN BRIEF, please tell us anything else interesting about yourself and/or your athletic career that might make for an interesting story. For example, perhaps you have a relative who played sports professionally or you have overcome a career-threatening injury or illness or maybe you excel in another field or hobby outside of sports. Please serious responses only!

This consent statement authorizes administrative personnel of the Department of Intercollegiate Athletics at Chapman University to review and disseminate to third parties information on this form and other education information contained, collected or maintained by Chapman University, for the purposes of public relations and publicity. The information on this form will assist in compilation of personal information for use in official departmental publications for the media and public, for the purposes of nominating me for honors programs, scholarships and awards, and for other public relations purposes deemed appropriate by officials of the Chapman University Department of Intercollegiate Athletics.

Also, by submitting this online form, I irrevocably authorize Chapman University, its employees, and its agents, to use my name, picture, and likeness as recorded by the University prior to the date of this Release for any purpose that the University deems appropriate, including promotional or advertising efforts.  I specifically authorize the University, its employees, and its agents, to use, reproduce, exhibit, or distribute my name and likeness for such purpose in any communications medium currently existing or later created, including without limitation print media, television, and the Internet.

Chapman Athletics
One University Drive | Orange, CA 92866
Ph: (714) 997-6691

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