BERRY COLLEGE STUDENT-ATHLETE QUESTIONNAIRE
ATTENTION STUDENT-ATHLETES:
This form is the basis for all sports publicity at Berry College. By completing this form, you are granting permission to be included in team rosters, photos, videos, stories and in various media outlets including newspapers, websites and television. Some photos taken may be made available for purchase. Additionally, you will have a personalized web page profile at www.berryvikings.com.

For the Office of Sports Information to effectively cover you and your team, you must complete this form in its entirety.

Failure to do so will greatly limit any publicity you will receive as a student-athlete at Berry.

Printed copies of this form will not be accepted. It must be submitted online before you arrive on campus for class.

FREEDOM OF INFORMATION ACT CLEARANCE

By completing this form, I give consent to the Berry College Office of Sports Information and Berry Athletics Department to release my grade point average and academic records to the media if I am selected as a winner of a scholar-athlete or team/individual academic award.

-Blake Childers, Berry College Director of Sports Information and Promotions

FULL NAME: *
(First Middle Last)
Your answer
Preferred name you would like used on rosters and in media releases (First & Last Name): *
(Ex: Quintorris Lopez Jones - "Julio Jones")
Your answer
Gender: *
Have you been officially accepted through the Berry College admissions office? *
SPORT(S): *
Required
Upcoming year of Competition: *
(Simply select the year for the upcoming season. Ex: If you will be starting school in August of 2017, select "2017-18")
Year of ATHLETIC eligibility for upcoming year: *
(In terms of NCAA eligibility)
Year of ACADEMIC study: *
Declared Major at Berry: *
Your answer
Minor (s):
(If applicable)
Your answer
Are you a transfer student? *
(If yes, also complete section 3 of this form in its entirety)
If YES, please list all colleges you attended and years attended:
Your answer
Student ID Number:
(From your Berry College Student ID Card)
Your answer
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