Men's Basketball Newcomer Questionnaire

 

The Simpson Athletics Communication Office publishes all informational material on Simpson student-athletes and keeps in contact with the media in their hometowns. To ensure we have current and accurate information, please take a few minutes to complete the questionnaire below.

By completing the following questionnaire and typing my signature below, I grant Simpson permission to use the included information as well as statistical and academic information for publicity purposes throughout my career. I waive any right to NOT have this information released under the Family Education Rights and Privacy Act (FERPA). Phone numbers and addresses will not be made public knowledge.


I  , on this day  give permission to the Simpson athletics communication office to compile and use all materials gathered by that office about my person for the conduct of that office. I also consent to the disclosure by Simpson College and to the extent defined below my academic grade point average directly related to me:
Records to be disclosed: A copy of my semester and cumulative GPAs
Purpose of disclosure: To release the academic performance of the student-athlete for purposes relating to: feature news stories, other Simpson publications and Academic All-Conference and Academic All-America nominations. This information may be publicized in electronic or print media.


Roster Information
Full Name (as you want it to appear on the roster)
 
Other sport(s) you in which you will participate (if any)
 
Year at Simpson during competition season
Fr. So. Jr. Sr.
Height (list as 5-11, 6-1, etc.)
 
Weight
 
Hometown, State
 
High School
 
Position
 
Hometown Newspaper(s)
 List newspapers that provided the best coverage during your high school career 
   
 
Personal Information
Date of Birth
 
Father's Name
 
Mother's Name
 
Major(s)
   
Minor
 
Names of brothers/sisters and ages (please note if siblings have ties to Simpson)
 
Family/Contact Information 
Your cell phone
  
Your non-Simpson email
  
Your Simpson address
Father's Address
  
Mother's Address (leave blank if same as above)
  
Father's phone
  
Mother's phone
  
 
High School Athletic Information 
High School
  
Year of Graduation
 
High School nickname (Bulldogs, Raiders, etc.)
 
Name of head coach
 
 
High School Bio
Write your bio using the following format, separated by ellipses. Include as much as or as little as you like. Tips: include all-district/all-conference honors, all-state honors, significant milestones or achievements (both individual and team) and other groups you were a part of, such as the National Honor Society, etc.):

A 2011 graduate of John Doe High School ... coached by Tim Smith ... named first team all-state by both the Des Moines Register and the Iowa Newspaper Association as a senior ... selected first team all-district as a senior and second team all-district as a junior ... holds school record for rushing yards in a game with 350 ... finished career with 3,450 rushing yards and 45 touchdowns ... a three-time academic all-district selection ... chosen first team all-conference in baseball as a junior ... also lettered in basketball and track ... a member of the National Honor Society.
 
Personal Bio
Again, share the information you would like included using the following format, making sure to include your birthdate, parents, siblings, and major/minor:

Born Dec. 24, 1992 ... son of John and Jane Doe ... has two sisters, Mary and Beth, and one brother, Tom ... majoring in biology with a minor in English.
Other sports in which you competed:
 Sport  Years Lettered 1 2 3 4
Sport  Years Lettered 1 2 3 4
Sport  Years Lettered 1 2 3 4
Sport  Years Lettered 1 2 3 4
 
Transfer Information
(fill out only if you are a transfer student)
Name of previous school
 
Sports played and years lettered
Sport  Years Lettered 1 2 3 4
Sport  Years Lettered 1 2 3 4
Significant honors, awards and achievements in sports listed above (separate honors with ...)