Athletics

CUW SPORTS INFORMATION STUDENT-ATHLETE PUBLICITY QUESTIONNAIRE

First Name *
Last Name: *
Sport(s) participating in at CUW: *
  Baseball
  Men's Basketball
  Men's Cross Country
  Football
  Men's Golf
  Men's Hockey
  Men's Lacrosse
  Men's Soccer
  Men's Tennis
  Men's Track & Field
  Wrestling
  Acrobatics & Tumbling
  Women's Basketball
  Women's Cross Country
  Field Hockey
  Women's Golf
  Women's Ice Hockey
  Women's Lacrosse
  Women's Soccer
  Softball
  Women's Tennis
  Women's Track & Field
  Women's Triatlon
  Volleyball
CUW academic major: *
Height (ex. 5-11):
Weight (if applicable):
Right/Left handed:
  Right
  Left
Right/Left footed:
  Right
  Left
Shoots (Hockey)
  Right
  Left
Baseball/Softball Bats:
  Right
  Left
  Switch
Baseball/Softball Throws:
  Right
  Left
Golf only - Swings
  Right
  Left
Twitter handle @:
Instagram handle:

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PERSONAL/CONTACT INFORMATION

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Email address *
Cell Phone Number: *
I give the Athletic Communications office permission to contact me via Text Message: *
  Yes
  No
Hometown (include city, state and zip code) *
Father's Name:
Mother's Name:
Names and ages of brothers:
Names and ages of sisters:
Position of birth (ex. first born):
Marital status (spouse's name):
Name and age of children (if applicable):

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OTHER INFORMATION

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Relative(s) who play(ed) professionally:
(Name, Relationship, Sport, College, Years Played)
Relative(s) who are famous or well-known and their relationship to you:
Any interesting stories of note about yourself:
Hometown Media Outlets
Newspaper(s), TV stations, Radio stations that your parents read regularly (include city and state)

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HIGH SCHOOL INFORMATION

Team Accomplishments  means items such as record, conference/regional/sectional/state championships or appearances, rankings, etc.
Personal Accomplishments means items such as team awards, all-conference, all-area, all-state, captains, records broken, etc.
Personal Statistics/Personal Bests means numerical items such as per game averages, running times, best marks

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Year of graduation: *
High school nickname/mascot
Full name of high school: *
Conference high school is a member of: *
Sport(s) participated in and year(s) lettered: *
(ex. basketball (4))
Team Accomplishments (years and type): *
(ex. basketball regional champions, sophomore)
Personal Accomplishments: *
(ex. set school record senior year, Honor Roll, etc.)
Personal Statistics/Personal Best: *
What is your biggest high school career highlight:

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JUNIOR TEAM, JUNIOR COLLEGE, TRANSFER OR PREVIOUS TEAM INFORMATION

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School/previous team nickname/mascot:
Previous school/team athletics and academic honors: (ex. first team all-conference, Honor Roll)
BE SPECIFIC WHEN LISTING SPORT AND ATHLETIC/ACADEMIC HONOR(S)
What is your biggest career highlight:
Previous school/team individual statistics:

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PERMISSION FOR RELEASE OF INFORMATION

By entering my name in the space below, I authorize permission to Concordia University Wisconsin's Athletic Communications Department to release my intercollegiate participatory sports records to the media requesting such information for publication or other use. I further authorize this institution to release such information which may include records earlier forwarded to this institution from high schools/colleges-universities/junior colleges attended by me, to the media by the Concordia University Wisconsin Athletic Communications Department. The released information may include any of the following: actual game participation statistics; pertinent personal data such as height, weight, position, age, hometown, college class status and past schools attended; athlete’s comments and image for use in personal feature articles and photographs, videos, drawings or slides. Excluded from the information for release are any academic records other than those of a positive nature such as for promotion with the mass media/coaches for conference and/or national athletic-academic honors or medical information protected by HIPAA.

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Electronic Signature (First & Last Name): *
Date: *
 
* = required field