AUGUSTA STATE UNIVERSITY
SAVANNAH STATE UNIVERSITY Try-out Form Office of Athletics Compliance STUDENT-ATHLETE INFORMATION Student Name: __________________________________ Eligibility Center ID: _____________________________
Sport:_______________________________________ SSU ID: 915- ____________________
*Students not registered with the Eligibility Center will not be cleared to try-out.
TRYOUT INFORMATION Date(s) of try-out:___________________
Location of try-out: ______________________
Time Try-out begins: Was this student recruited?
Yes
No
Signature of Coach responsible for try-out *This form for tryout must be submitted to the Office of Athletics Compliance 5 days prior to Official try-out date.
SPORTS MEDICINE CLEARENCE Has the student undergone a physical within 6 months?
Yes
No
Date_________
*(Must provide a current copy)
Provided a copy of a sickle cell solubility test?
Yes
No
Provided proof of current personal /University issued insurance? Yes
No
Date_________
Comments: __________________________________________________________________________________ __________________________________________________________________________________ *All student- athletes are required to bring proof of a physical conducted by an MD no later than 6 months prior to the tryout date. *All medical documentation must be submitted along with this form to the Office of Compliance prior to try-out date. *If student does not have proof of personal insurance/University insurance (Sports Rider) the student will not be cleared.
Athletic Trainer Signature
Date
TO BE COMPLETED BY THE OFFICE OF ATHLETICS COMPLIANCE Registered with the NCAA Eligibility Center? Certified as:
Qualifier
Amateurism Certified: SA has permission to:
Non-Qualifier Final Certified Try-Out
Assistant A.D. for Compliance Signature
YES
NO
Preliminary Non-Qualifier Certified w/ Conditions
No Decision
Preliminary Certified
Pending: _______ Pending: ______
NO Try Out
Date
9/15 Savannah State University is a Division I member of the National Collegiate Athletics Association and is sponsored by the University System of Georgia
Sport:_______________________________________ SSU ID: 915- ____________________
*Students not registered with the Eligibility Center will not be cleared to try-out.
TRYOUT INFORMATION Date(s) of try-out:___________________
Location of try-out: ______________________
Time Try-out begins: Was this student recruited?
Yes
No
Signature of Coach responsible for try-out *This form for tryout must be submitted to the Office of Athletics Compliance 5 days prior to Official try-out date.
SPORTS MEDICINE CLEARENCE Has the student undergone a physical within 6 months?
Yes
No
Date_________
*(Must provide a current copy)
Provided a copy of a sickle cell solubility test?
Yes
No
Provided proof of current personal /University issued insurance? Yes
No
Date_________
Comments: __________________________________________________________________________________ __________________________________________________________________________________ *All student- athletes are required to bring proof of a physical conducted by an MD no later than 6 months prior to the tryout date. *All medical documentation must be submitted along with this form to the Office of Compliance prior to try-out date. *If student does not have proof of personal insurance/University insurance (Sports Rider) the student will not be cleared.
Athletic Trainer Signature
Date
TO BE COMPLETED BY THE OFFICE OF ATHLETICS COMPLIANCE Registered with the NCAA Eligibility Center? Certified as:
Qualifier
Amateurism Certified: SA has permission to:
Non-Qualifier Final Certified Try-Out
Assistant A.D. for Compliance Signature
YES
NO
Preliminary Non-Qualifier Certified w/ Conditions
No Decision
Preliminary Certified
Pending: _______ Pending: ______
NO Try Out
Date
9/15 Savannah State University is a Division I member of the National Collegiate Athletics Association and is sponsored by the University System of Georgia
