Western New Mexico Athletics

The information provided on this questionnaire will be used for publicity purposes. It is to the student-athlete's advantage to fill out this form as completely and honestly as possible.

Please be specific about athletic achievements by listing the sport, what organization gave you the award, and the year. For example: Baseball - Team MVP (2010); Volleyball - All-Sierra Valley Conference First Team (2008); Basketball - Modesto Bee All-District First Team (2009); 3-Year Letterwinner (2010).

*Required Field

Sport -- Please do not forget to change the sport! *	Football General Men's Basketball Men's Cross Country Men's Golf Men's Tennis Softball Volleyball Women's Basketball Women's Cross Country Women's Golf Women's Tennis
Position (if applicable)
Year of Athletic Eligibility *	FreshmanSophomore JuniorSenior
Academic Class	FreshmanSophomore JuniorSenior
Personal Information (contact information is for internal use only and will not be released to public without permission)
First Name *
Middle Name
Last Name *
Name You Prefer For Release (how it appears in the media guide, website, press releases, etc.)
Parents' Full Names (first & last)
Home Address (not campus address)
Home City & State *
Home Zip Code
Email Address *
Phone Number
Birthdate (mm/dd/yyyy) *
Major *
Minor
Local Address
Street Address
Zip Code
For Returning WNMU Student-Athletes Only: Is all the remaining information the same as last year? If so, click yes here and move to the very last question. Skip question if new to WNMU.	YesNo
High School Information
High School
High School City & State
Year Graduated
Bio Information
Height (i.e., 5-9)
Weight (lbs) - required for males
High School Coach
High School Awards/Honors
High School Team Accomplishments
Other Activities at Western New Mexico
High School Academic Awards
College Academic Awards
Career Objectives
Junior College Information (if applicable)
Name of Junior College
City & State
Years Attended (i.e., 2005-07)
Junior College Awards/Honors
Junior College Team Accomplishments
Another University/College Attended (if applicable)
Name of University/College
City & State
Years Attended (i.e., 2005-07)
Awards/Honors
Other Team Accomplishments
Club Team (if applicable)
Club Team Name
Club Coach
Club Team Awards/Honors
Club Team Accomplishments
Hometown Media Information (Please fill out completely, entirely, and accurately or else we are unable to send your information back home during the season.)
Hometown Newspaper #1
Sports Email Address
City & State
Hometown Newspaper #2
Sports Email Address
City & State
Hometown Television Stations (Just list names of stations)
Email Address of Television Station(s)
Hometown Radio Stations (Just list names of stations)
Email Address of Radio Station(s)
Additional Information
Spouse's Name (if applicable)
Years Married
Names and Ages of Children (i.e., Emily, 2; Jacob, 11 months)
Relatives who played college or professional sports (i.e., John Smith, uncle, basketball, Sacramento Kings, 1987-89)
Hobbies and Interests
Favorite Pro Sports Teams
Favorite Book & Author
Favorite Movie
Favorite Musician
Other Favorites (write in your own)
Authorization to Release Information
I have, to the best of my knowledge, filled out this form accurately and honestly. I also agree to allow Western New Mexico to release any information that promotes myself, the team, or the University. (Example: GPA for all-academic teams) *	YesNo