2004 Conference Registration Form
NLI/Scholarship Request NLI Request
ATHLETIC COMPLIANCE OFFICE
Scholarship Request
Sport
Personal Information
Academic Year
Prospect's Name
Date of Birth
NCAA ID
E-mail Address
Enrollment Information Initial Enrollment at Southeast
2-4 NonQual.
First Time Full-Time
2-4 Qual.
Undergrad
Graduate
Residency Status
Resident
Non-Resident
Housing Information
Off-Campus
On-Campus
4-4
Dorm
Scholarship Information Period of Award
Full Academic Year
Fall Semester Only
Hour Limitation
__________ Hours
N/A
Spring Semester Only
Type of Award Full Scholarship (Tuition, General Fees, Textbook Rental, and Room & Board) Partial Scholarship (Please complete below): Tuition
Full
$ __________
% __________
General Fees
Full
$ __________
% __________
Textbook Rental
Full
$ __________
% __________
Room & Board
Full
$ __________
% __________
Cost of Attendance
Full
$ __________
% __________
Flat Dollar Amount $
(to be divided evenly if awarded for full academic year)
% of Full __________ reduce scholarship by any non-athletically related aid the SA receives?
Yes
No
reduce scholarship by any other Countable aid the SA receives?
Yes
No
Comments: NOTE: If a student-athlete will also receive a university academic scholarship, the university scholarship will be applied to a student's account first. This is an automatic process. NOTE: An athletics financial aid award will not be applied to a student's account unless the student has completed a Free Application for Federal Student Aid (FAFSA).
I certify that the above information is accurate and complete and give my approval to issue the scholarship agreement. Signature of Coach Distribution:
Date Student Financial Services
Coach
Student File
ATHLETIC COMPLIANCE OFFICE
Scholarship Request
Sport
Personal Information
Academic Year
Prospect's Name
Date of Birth
NCAA ID
E-mail Address
Enrollment Information Initial Enrollment at Southeast
2-4 NonQual.
First Time Full-Time
2-4 Qual.
Undergrad
Graduate
Residency Status
Resident
Non-Resident
Housing Information
Off-Campus
On-Campus
4-4
Dorm
Scholarship Information Period of Award
Full Academic Year
Fall Semester Only
Hour Limitation
__________ Hours
N/A
Spring Semester Only
Type of Award Full Scholarship (Tuition, General Fees, Textbook Rental, and Room & Board) Partial Scholarship (Please complete below): Tuition
Full
$ __________
% __________
General Fees
Full
$ __________
% __________
Textbook Rental
Full
$ __________
% __________
Room & Board
Full
$ __________
% __________
Cost of Attendance
Full
$ __________
% __________
Flat Dollar Amount $
(to be divided evenly if awarded for full academic year)
% of Full __________ reduce scholarship by any non-athletically related aid the SA receives?
Yes
No
reduce scholarship by any other Countable aid the SA receives?
Yes
No
Comments: NOTE: If a student-athlete will also receive a university academic scholarship, the university scholarship will be applied to a student's account first. This is an automatic process. NOTE: An athletics financial aid award will not be applied to a student's account unless the student has completed a Free Application for Federal Student Aid (FAFSA).
I certify that the above information is accurate and complete and give my approval to issue the scholarship agreement. Signature of Coach Distribution:
Date Student Financial Services
Coach
Student File
