Chapman University Student Athlete Questionnaire |
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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.
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Email address
*
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First name
*
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Last name
*
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Preferred Name
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Please select which sport(s) you play at Chapman
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Eligibility Year
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| (Fr., So., Jr., Sr.) |
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Postion
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Height
*
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Weight
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Birthday/Age
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Major
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Minor
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Permanent Address
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Home Phone
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Cell Phone
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Email
*
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"Home" Town
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High School
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Year Graduated
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High School Varsity Sports Played:
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| School (High), Sport (Soccer), Years (2007-09), Position(s) (DEF,GK) |
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Junior College Sports Played:
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| School (JC), Sport (Soccer), Years (2009), Postion(s) (GK) |
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Other Four-Year College Sports Played:
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| School (Univ.), Sport (Soccer), Years (2010), Position(s) (GK) |
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ATHLETIC Honors & Rewards - 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.
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High School
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College
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ACADEMIC Honors & Awards - Please list any
awards on academic achievement (can be combined with athletic
achievement, i.e. Scholar Athlete. Include Who's Who, honor
societies, Deans Lists, scholarships, etc.
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High School
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College
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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!
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Below:
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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.
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| * = required field |
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