Athletics

CUW SPORTS INFORMATION STUDENT-ATHLETE PUBLICITY QUESTIONNAIRE

Sport(s) participating in at CUW: *






























Right/Left handed:


Right/Left footed:


Shoots (Hockey)


Baseball/Softball Bats:



Baseball/Softball Throws:


Golf only - Swings


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PERSONAL/CONTACT INFORMATION

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I give the Athletic Communications office permission to contact me via Text Message: *


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OTHER INFORMATION

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(Name, Relationship, Sport, College, Years Played)
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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(ex. basketball (4))
(ex. senior year basketball regional champions, sophomore year conference champions)
(ex. set school record senior year, Honor Roll, etc.)

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JUNIOR TEAM, JUNIOR COLLEGE, TRANSFER OR PREVIOUS TEAM INFORMATION

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BE SPECIFIC WHEN LISTING SPORT AND ATHLETIC/ACADEMIC HONOR(S)

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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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* = required field