Salve Regina University Athletics - Student Athlete Publicity Form

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Student-athlete biographical information

If you would like us to use a name other than your full first name on the web site and other materials (e.g. "Bob" for "Robert") please provide one here
Gender *
Numbers only; no other characters
Male athletes only
You may advance to the bottom of page to submit after completing this area

All NEW student-athletes should complete the remainder of this form

List dates attended and sport(s) played
First Last
List name(s) with age(s)

Please tell us more

These are some of your favorite things


Briefly describe why you may have a story for our media outlets (includes Report From Newport)
Use this space to enter non-U.S. home address; Twitter and/or Instagram; other pertinent information

By clicking "Submit" I hereby authorize the athletics communications office to use some or all of the information listed above and any other present and future information about me as a student (including grade-point averages exceeding 3.0) and athlete at Salve Regina University, as well as any photos taken by or for the athletic department, for sports publicity and information purposes. Contact information is 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 of the University.

* required field