Autograph item request form

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UNIVERSITY OF NEW MEXICO

Athletic Compliance Office

Autograph item request form

Completed form and supporting documentation must be submitted to the UNM Athletic Compliance Office via email at [email protected]. You may contact the Compliance Office with questions or concerns at (505) 925-5835. No more than two (2) items can be requested for autographs unless given special approval.

Requester information Name

Date of Request

Email Address

Telephone #

Item(s) to be provided by Requestor

Quantity Blank

Autograph Requested (i.e. name(s) and/or sport)

Purpose of request Blank Organization Name

Telephone #

Street Address

City

State Blank

Zip

Organization classification Blank Will the item be sold or auctioned for fundraising purposes? Blank (Attach flyer or memo describing the event) If yes, will high school aged student benefit from the sale?

Blank

PLEASE NOTE THAT NCAA RULES PROHIBIT US FROM PROVIDING ITEMS TO FUNDRAISERS THAT WILL BENEFIT PROSPECT-AGED INDIVIDUALS.

What organization will receive the proceeds from the sale?

Statement of understanding

By my signature below, I certify that the item provided to me per this request will be used only in the manner I specify above. I understand that this item may not be given as a gift to a prospect aged individual. I understand that this item may not be sold for personal profit nor donated to a fundraising activity unless designated as such above. If I am giving this item as a gift, I certify that I will notify the recipient of the applicable regulations. Lastly, I understand that this item may not, under any circumstance, be re-sold or auctioned through the internet (i.e., EBay, etc.) Requestor’s Signature:

Date:

For office use only: Compliance Approval Blank

Compliance Signature

Request Forwarded to:

Date

Email to Compliance This is a request and not a guarantee that a Autograph will happen