Coker College Student-Athlete Sports Information Questionnaire

PLEASE FILL-IN EVERY BOX & MAKE SURE YOU COMPLETE THE DATE AT THE BOTTOM BEFORE SUBMITTING.

STUDENT-ATHLETE CONTACT INFORMATION
Full Name:
Sport (Specify men's or women's):
Position:
Year at Coker: (Freshman, Sophomore, etc.)
Name as you would like it to appear in publications: (Ex. Mike instead of Michael)
Permanent Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Email Address:
HIGH SCHOOL INFORMATION
High School:
High School Mascot:
Sports played in high school:
High School Stats and Athletic Accomplishments: (PLEASE BE SPECIFIC- Please spell out conference and state affiliations. Please sperate sport accomplishments.)
COLLEGE OR JUNIOR COLLEGE INFORMATION- DOES NOT APPLY TO FRESHMEN
College or Junior College:
Sports played:
Other College Stats and Accomplishments:
TRAVEL, CLUB OR AAU TEAM INFORMATION
Travel Team, Club Team or AAU Team:
Travel, Club or AAU Stats and Accomplishments:
ACADEMIC INFORMATION
Academic Accomplishments: (Ex. Honor Roll)
Clubs and Organizations:
PERSONAL INFORMATION
Date of Birth:
Place of Birth:
Major:
Height:
Weight: (men only)
Parent's Names: (If you have stepparents, please include)
Did your parent(s) play a sport in college? If yes, please list where, when, the sport and any honors:
Siblings: (Please list ages and school, if they are enrolled in college)
If you have sibilings in college, do they participate in sports? Also, any professional playing experience with details:
Has anyone else in your family attended Coker College? If so, when did they graduate and did they play any sports?

Any questions or for additional information, contact Christian Stryker, Director of Sports Information at cstryker@coker.edu

By clicking the submit button below, you signify you authorize the sports information department at Coker College to use all of the information listed above, as well as photographs and any other present or future information about me as a student-athlete at Coker for sports publicity and information purposes. I grant this authorization as a waiver to my rights under the Education Ammendment of 1972 to restrict the release of information to persons outside the University. I also acknowledge personal information such as phone numbers, addressess and social security numbers are for office use only.

DATE: