MCC Athletics Questionnaire

Email address *

This information will be used to create your bio for the website and media guide.

Last Name *

Middle Name

First Name *

First name you prefer to use (such as Jonathan might be John)

Sport(s) at MCC *

Year in School *

Personal Information

Date of Birth *

Place of Birth (City and State) *

Hometown (the place you consider your home, not necessarily where you live now) *

Name of newspaper nearest your home

Height *

Weight

Bat (Baseball or Softball only)

Throw (Baseball or Softball only)

Personal Bests (Cross Country / Track & Field only)

High School *

High School mascot (such as T-Birds, Tigers, etc.)

Year of Graduation *

High School coaches' full name (ex: John A. Smith) *

Academic Major at MCC (Program of Study) *

Family Information

Father's (or Guardian) Name

Mother's (or Guardian) Name

How would you like your parents listed (ex: Joe and Mary Smith or Mr. and Mrs. Joe Smith, etc.)

Brothers with names and ages (if applicable)

Sisters with names and ages (if applicable)

Relatives who have competed in college or professional sports (Please include relationship to you, name, sport, team, and when)

Other sports you have competed in during high school

High School athletic honors (all-conference, all-state, records set, etc.). Be specific as to when these honors were awarded.

Have you ever competed at another college before? *

If yes, please list college, dates, sports, etc.

High School academic honors (honor roll, awards received, honor societies)

High School activities other than sports

Community Service / Volunteer Work

Jobs or other activities

By checking this box I authorize Mesa Community College to release my intercollegiate sports records to media requesting such information for publication or other use. I further authorize this institution to release such information which may include records either forwarded to this institution from high schools or other colleges attended by me to the MCC Sports Information Office. The released information may include any, or more, of the following: actual game participation statistics, pertinent personal data such as height, weight, age, hometown, grade-point average, college class status and past schools attended for use in personal feature articles and photographs, film, drawings or slides, pertinent medical information (in consultation with the team trainer/doctor and coach). Excluded is any academic information other than those of a positive nature, including public academic ceremonies. This release is given at the request of guidelines imposed by the Family Education Rights and Policy Act of 1975. *

Yes

* required field