Student-Athlete Media Relations Information Form

Dear StonehillStudent-Athlete:

This form will be used by the athletic media relations department for information purposes. The information gathered will be used to create a biography for the website. Additionally, I may need your contact phone number should a member of the media request an interview.

Please take a few minutes and complete the form in its entirety. Remember, the moreinformation you provide, the more detailed your biographical information will be. Please be as specific and detailed as you can. For example, if you were named all-conference as a senior, what was the name of the conference? If you were MVP, were you the school MVP? Conference MVP? Treat this as an athletic resume – list as many highlights and accomplishments as you can in as much detail as you can. If you need more space, feel free to attach a resume or a list of your athletic and academic accomplishments.

Please include your hometown as well as your home street address and include your major as you prepare to enroll at Stonehill even if you plan to change it.

This is the only time you will be asked to complete this form during your time here at Stonehill.Please complete everything on this form, however, if you wish to update any information in the future, please contact us at the email address below.

Lastly, please make sure you sign the bottom of this form. If you have any questions, please feel free to email me at r call me at 508-565-1352.

Best Wishes,

Doug Monson

Assistant Athletic Director, Communications

Stonehill College

Stonehill College Athletic Communications Student-Athlete Information Form

Name: ______Date of Birth:______Place of Birth: ______

Sport(s):______Class: ______Height: ______Weight:______

Position(s): ______Major/Minor:______

Hometown:______

Cell Phone: ______Home Phone: ______

Father’s Name: ______Mother’s Name ______

Father’s Occupation: ______Mother’s Occupation ______

Indicate here only if parents are divorced or one or both deceased: ______

If parents are separated/divorced, etc., please indicate how you wish to have them listed in your bio:

Example: Is the son/daughter of Jane Smith of anytown and John Smith of different city. ______

Sibling’s Names (Ages): ______

High School Athletic/Academic Honors(List team record, coach and positions played as well as any awards/records)

High School Name: ______Sport(s): ______

Freshman: ______

______

Sophomore: ______

______

Junior: ______

______

Senior: ______

______

Club Teams/Prep School: ______

Hobbies/Recreational Activities: ______

Why did you pick Stonehill: ______

Has any family attended Stonehill? If so, did they participate in any sports? Have any of your parents, siblings or extended family members played sports at Stonehill or another college?

______

Favorite team:______Favorite athlete: ______

Previous College Athletic/Academic Honors(List team record, coach and positions played as well as any awards/records)

______

______

Hometown newspapers: ______

Buckley Amendment Waiver:In accordance with the Buckley Amendment, I hereby authorize Stonehill College and the media relations office to release any pertinent athletic information to the media and also authorize the media relations office to release any pertinent information, including GPA for academic-related awards.

______

Student-Athlete signature Date