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Bemidji State University

Questionnaire 2009-10 Athletic Media Relations Questionnaire

Volleyball Full Name: first, middle, last

Fr Athletic Eligibility Used Redshirt Year? Y Height: Birthday: R Dominant hand: Home Town:

So N





Year in School: 1





Weight: Birthplace: Position:

this will be listed as your home town on rosters in media guides, game notes, web sites, etc.

Home Town Newspaper: Home Address: Home Phone: CONTACT INFORMATION Local Address: Local Phone: Cell Phone: e-mail: Contact information is strictly confidential and will never be released to media outlets. It is for sports information office use only.

Father’s Name: Father’s Occupation: Father’s College: Mother’s Name: Mother’s Occupation: Mother’s College: Relatives who participated in college or professional sports: Please be as detailed as possible; include names, relationship to you, sports and years played. Could be used to generate feature stories.


Other Schools Which Offered You A Scholarship:

• You must complete the back of this form; please sign & date Brad Folkestad, Director of Atheltic Media Relations ❑ ❑ Bemidji, MN 56601-2699 ❑ 218-755-4603 ❑

Athletics Information

Relate the greatest thrill or other special accomplishment of your athletics career:

High School/conference: High School Coach: Letters Won (all sports): Academic Honors:

Dean’s List, Nat’l Honor Society, Honor Roll, Academic Letter, etc.

other history (if attended; include years) Junior College/ Club: J.C. / Club Coach: Prev. University(s): College/Univ. Honors:

Why did you choose BSU? Your major area of study: BSU Academic Honors: list honor and year received, including scholarships

Previous Athletics History Any high school or college history prior to coming to BSU. Please be as detailed as possible and include information on your team. Include personal records set, game and season, team and individual highlights/post season highlights/team win/loss record/championships/playoff berths.

I hereby agree this information is accurate and can be used in an informational manner by the Bemidji State University Sports Information Department in its publications and news release programs. • I grant the Sports Information Department permission to access and release information regarding my playing status as related to injury or actions taken by coaching staffs or administrators to media and other entities affiliated with BSU Athletics. • I grant the Sports Information Department permission to access and release my grade point average only as related to the nomination process for academic awards and honors for myself or my team, and for publicity of such awards.

Signature: Date: