How would you like your name to read in the media guide?
Position or event
Height * (ft/in)
* Weight (male only)
Handed / Footed *
Baseball/Softball only: Bat
City of Birth
* State of Birth
Date of Birth (mm/dd/yyyy)
Academic Year in School
Athletic Year in School
Please give as complete an address as possible. If dorm, state which dorm you live in.
Best phone number to be reached at
Permanent Home Address (Address, City, State, Zip)
Parent's phone number
Do you have any relatives who are or have been involved in college or professional athletics?
(Please list name, relationship to you, sport, team, and years)
Why did you choose Trine University?
What are your athletic goals?
What has been the biggest influence on you as an athlete and why?
Most memorable sports achievement
What is your career goal?
High School History
Name of High School
High School Graduation Year
Year, Sport, Position, Team Record, Coach's name, how team fared (titles won, level of playoffs reached) *
I.e. 1990 Basketball G 10-2 Jim Smith League and District Champs.
Athletic Achievements and Honors (please be specific, listing the year of each award. Also include records set, championships won, "All-League" or other teams you were name to, all-star games played in, letters won in each sport.) *
Non Athletic Information
High School Academic Honors *
High School Activities besides Athletics *
Community Service or Volunteer Work *
Collegiate History (including Trine)
Prior college attended (if applicable), location, years of attendance
Year, Sport, Position, Team Record, Coach's name, how team fared (titles won, level of playoffs reached)
Athletic Achievements and Honors (please be specific, listing the year of each award. Also include records set, championships won, "All-League" or other teams you were name to, all-star games played in, letters won in each sport.)
Hometown Publicity Outlets
List the name of the newspaper in or near your hometown, and the name of the paper in the nearest big city:
Do you know anyone at the paper? If so, please give the name
What is the best TV station for local sports in your hometown?
Permission for the release of information
I, the undersigned, authorize Trine University, to release my intercollegiate participatory sports records to the media requesting such information for publication or other use. I further authorize the institution to release such information which may include records earlier forwarded to this institution from high school and other colleges attended by me to the media by the Trine sports information office. The released information may include the following: actual game participation statistics, pertinent personal data such as height, weight, position, age, hometown, college class status and past schools attended, comments for use in feature articles and photographs, films, drawings or slides, pertinent medical information in consultation with the team trainer, doctor and coach. Excluded from this information for release are any other academic records other than those of a positive nature such as for promotion with the mass media for conference or national athletic academic honors.
* (Your signature)
This release is given at the request of the guidelines imposed by the Education Rights and Privacy Act of 1975.