Bay State Games Communications Publicity Questionnaire

The information you provide on this form will be used as background material for our publicity endeavors such as Bay State Games recruiting brochures, hometown releases, and requests from the media. Completion of this form renders consent on your behalf for Bay State Games to promote your accomplishments. Please fill out this form accurately and completely and send it to the Bay State Games office at . If any information needs to be updated at a later time, please call (781) 932-6555 or stop by our e-mail . Thanks for your assistance.

SPORT(S) EXPECTED TO PLAY AT BAY STATE GAMES

Name

(Last) (First) (Middle) Last Name Pronunciation (If Necessary)

Name You Go By (If Different/Shortened From Your First Name) ______Home Phone

Home Address City State

Country ZIP ______Date of Birth HeightWeight

Home Phone Cell Phone Twitter User Name @ follow us at @BayStateGames

E-Mail GPA SAT Score ACT Score

Parents/Guardians (list both first names/list last names if necessary)

Any Family Situation You May Want Us To Know (optional)

If You Consider Another Town As Your Hometown, Please List

Father's College Mother's College

Hometown Newspapers (Daily/Weekly) and Other Media Outlets Interested In Your Athletic Progress

High School Year in school Yrs. Attended: 20 to 20

Year of Graduation

Prep High School (if applicable) ______Yrs. Attended: ______20 _____ to 20

Varsity Sports Played (Indicate Years Lettered/Started, and Positions Played; primary and secondary) ______

At BatsThrows

Formal Name of League and/or County Your School Played In

Team(s) Captained & Year(s)

Athletic Honors Won—Be Complete (All-City, All-League, All-State, Tournament/Team MVP, Etc.—indicate year, sport, etc.)

______

Outstanding Individual/ Team Performances (School, League, State Records for Game, Season, Career; Team Streaks, Titles, Etc.)

______

Academic Recognition and Extra Curricular/Community Service Involvement (List Years, Organizations, Honors Won, Etc.)

______

______

Other Interests (also hobbies, collections, etc.)

Relatives who have participated in the Bay State Games (note relationship, name, graduation year, any sports played, etc.)

Other Relatives Who Have Excelled in Athletics (note relationship, name, sport or when and where)

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