Student - Athlete Profile

This form assists the Sports Information Department at Ursinus College in promoting your accomplishments during the year. Please fill out this form as accurate and detailed as possible. If you have any questions, please email Jim Wagner, Sports Information Director at jwagner@ursinus.edu.  

Personal Information
Full Name
Birth Date
Cell Phone Number
Email Address

Roster Information
Preferred Name (How you want it listed on the website/program)
Phonetic Pronunciation of Name (How you say your last name)
Sport Number 1 You Play
Position/Events For Sport Number 1
Sports Number 2 You Play
Position/Events For Sports Number 2
Bats/Throws (For Baseball/Softball Players Only)
Height
Weight (Male Athletes Only)
Class
Hometown
High School

Hometown Media Information
Newspaper #1
Television Station
Radio Station
Newspaper #2

Parent/Guardian Information
Full Name of Parent/Guardian #1
Relationship to You
Full Name of Parent/Guardian #2
Relationship to You

High School Accomplishments
High School Sports Played 
High School Accomplishments/Awards

Ursinus College Information
Major(s)
Minor(s)
Planned Career
Athletic Accomplishments
Academic Honors
Extracurricular Activities

Track & Field/Cross Country/Swimming ONLY - Personal Best Performances
Event #1
Event #1 Time/Hgt/Dis
Event #2
Event #2 Time/Hgt/Dis


 By filling out this form, you authorize the Ursinus College Sports Information Department to use all of the information listed above and any other present and future information about you as a student (including G.P.A's, both semester and cumulative, exceeding 3.0) to assist in sports publicity. Addresses and phone numbers will be kept confidential. I grant this authorization as a waiver to my rights under the Education Amendment of 1972 to restrict the release of information to persons outside the college.