Student-Athlete Media Services Information Questionnaire
The information obtained by the Western Illinois Athletics Media Services Department aids the office in the preparation of media guides, game notes, press releases, and serves as background information for interested members of the media.

Required Fields in Bold

Date Completed
 
Sports participating in at Western
 
Name
 
Name to be used (if different)
 
Position
 
Height
 
Weight
 
Birth date
 
Academic Year
 
Year of Eligibility (If different):
 
Major
 
High School Attended
 
Junior College Attended
 
Hometown
 
Current Home Mailing Address
 
Legal Guardian(s) / Parent(s)
 
List of family members that have competed in college or professional sports (Please include sport, school/team, years, position)
 
List any high school teammates now participating in athletics at Western Illinois
 
Daily or weekly newspapers in your area (If a particular writer covered please include their name)
 
 
List all sports played in high school (Sport, coach, position, # of varsity letters won)
 
List any high school academic honors and athletic honors (Include years)
 
List any high school statistical notes of interest (Include career totals, career highs, records, etc.)
 
List any junior college academic honors and athletic honors (Include years)
 
List any junior college statistical notes of interest (Include career totals, career highs, records, etc.)
 
Why did you choose Western?
 
What is your most memorable moment in your sport?
 
Who has been the major influence on your sports career and why?
 
List your Hobbies/Interests:
 
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