Community Outreach Request Form
Wichita State University Athletics Student-Athlete Community Outreach Compliance Request Form Wichita State student-athletes are eager to give back to the community which provides great support throughout their careers; however, there are numerous time constraints coupled with NCAA rules that determine if requests can be accommodated. Student-Athlete Service Request Policy 1) Student-athletes are not permitted to engage in outreach during the first and last two weeks of each semester. 2) Requesting student-athletes to appear for autograph signing or general appearances will not be approved. An element of service must be involved in the request. 3) During the summer months, student-athletes are in accelerated class loads with extended meeting times along with combining employment, internships and workouts. Requests will be accepted during the summer months, but are often difficult to accommodate. 4) The event must be within a 30-mile radius of Wichita State University. 5) Student-athletes will not attend events that cause them to miss games, practices, meetings, or any other institutional obligations. For this reason, it is unlikely that student-athletes will be able to accommodate requests during a sport’s playing season. 6) WSU Athletics cannot guarantee that it will be able to offer student-athletes who are specifically identified in requests for appearances at events. The requester will be notified if there is intent to offer a different participant. 7) WSU Athletics reserves the right, for any reason, to deny appearance requests. 8) Due to the high volume of requests received, importance of documentation and need for approval from compliance, those requesting student-athletes must complete this form. 9) During the time of the event, there will be no individual photographs with student-athletes and no autographs given by the student-athletes. In order to be considered, all requests much be received at a minimum, at least two weeks in advance of the proposed event. Agency/Organization Information Agency/Organization Name: Please check the box that best describes your Agency/Organization above: □ Educational Institution
□ Charitable
□ Nonprofit Organization
Contact Name:
Contact Title:
E-mail:
Contact Phone #:
□ Other___________________
Event Information Event Requested: Location/Address of Event: Date Requesting:
Possible other dates:
Start/End Time:
Number of student-athletes requesting: 1
Please explain the purpose of the event: ____________________ What is the anticipated role of the student-athlete:
Target Audience:
Target Audience Size:
Special Instructions for arriving at event:
NCAA Compliance Information Does this event involve 9th graders or above in the audience? □ Yes
□ No
Is there sponsorship from a commercial agency/for-profit business involved with your event? □ Yes □ No If yes, please explain:
Will the student-athlete’s name/appearance be used to promote the event?
□ Yes
□ No
Is this a fundraising event? □ Yes □ No If yes, what will the funds be used for or benefit?
Will the event involve any athletic participation? If yes, please explain:
□ Yes
□ No
Will you be involving any media coverage for your event? If yes, please indicate:
□ Yes
Will the involved student-athletes be receiving a meal? □ Yes
□ No
Is a photographer permitted at your event? □ Yes Please indicated the limited restrictions:
□ Limited
□ No
□ No
My signature below indicates that I have read the NCAA rules on page 3 and certify that the activity/event listed above in which the student-athlete(s) will participate meets all NCAA requirements.
Agency/Organization Representative Signature
Date
Compliance Office Approval
□ Event Approved □ Event NOT Approved Compliance Office Signature
Date
Please return Page 1 & 2 via e-mail to [email protected] or by fax at (316) 978-5330.
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NCAAA Bylaw 12.5.1.1 A member institution or recognized entity thereof (e.g., fraternity, sorority or student government organization), a member conference or a noninstitutional charitable, educational or nonprofit agency may use a student-athlete's name, picture or appearance to support its charitable or educational activities or to support activities considered incidental to the student-athlete's participation in intercollegiate athletics, provided the following conditions are met: (a) The student-athlete receives written approval to participate from the director of athletics (or his or her designee who may not be a coaching staff member) (b) The specific activity or project in which the student-athlete participates does not involve co-sponsorship, advertisement or promotion by a commercial agency other than through the reproduction of the sponsoring company's officially registered regular trademark or logo on printed materials such as pictures, posters or calendars. The company's emblem, name, address, telephone number and website address may be included with the trademark or logo. Personal names, messages and slogans (other than an officially registered trademark) are prohibited; (c) The name or picture of a student-athlete with remaining eligibility may not appear on an institution's printed promotional item (e.g., poster, calendar) that includes a reproduction of a product with which a commercial entity is associated if the commercial entity's officially registered regular trademark or logo also appears on the item; (d) The student-athlete does not miss class; (e) All moneys derived from the activity or project go directly to the member institution, member conference or the charitable, educational or nonprofit agency; (f) The student-athlete may accept actual and necessary expenses from the member institution, member conference or the charitable, educational or nonprofit agency related to participation in such activity; (g) The student-athlete's name, picture or appearance is not used to promote the commercial ventures of any nonprofit agency; (h) Any commercial items with names, likenesses or pictures of multiple student-athletes (other than highlight films or media guides per Bylaw 12.5.1.7) may be sold only at the member institution at which the studentathletes are enrolled, the institution's conference, institutionally controlled (owned and operated) outlets or outlets controlled by the charitable, educational or nonprofit organization (e.g., location of the charitable or educational organization, site of charitable event during the event). Items that include an individual studentathlete's name, picture or likeness (e.g., name on jersey, name or likeness on a bobble-head doll), other than informational items (e.g., media guide, schedule cards, institutional publications), may not be sold; and (i) The student-athlete and an authorized representative of the charitable, educational or nonprofit agency sign a release statement ensuring that the student-athlete's name, image or appearance is used in a manner consistent with the requirements of this section.
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□ Charitable
□ Nonprofit Organization
Contact Name:
Contact Title:
E-mail:
Contact Phone #:
□ Other___________________
Event Information Event Requested: Location/Address of Event: Date Requesting:
Possible other dates:
Start/End Time:
Number of student-athletes requesting: 1
Please explain the purpose of the event: ____________________ What is the anticipated role of the student-athlete:
Target Audience:
Target Audience Size:
Special Instructions for arriving at event:
NCAA Compliance Information Does this event involve 9th graders or above in the audience? □ Yes
□ No
Is there sponsorship from a commercial agency/for-profit business involved with your event? □ Yes □ No If yes, please explain:
Will the student-athlete’s name/appearance be used to promote the event?
□ Yes
□ No
Is this a fundraising event? □ Yes □ No If yes, what will the funds be used for or benefit?
Will the event involve any athletic participation? If yes, please explain:
□ Yes
□ No
Will you be involving any media coverage for your event? If yes, please indicate:
□ Yes
Will the involved student-athletes be receiving a meal? □ Yes
□ No
Is a photographer permitted at your event? □ Yes Please indicated the limited restrictions:
□ Limited
□ No
□ No
My signature below indicates that I have read the NCAA rules on page 3 and certify that the activity/event listed above in which the student-athlete(s) will participate meets all NCAA requirements.
Agency/Organization Representative Signature
Date
Compliance Office Approval
□ Event Approved □ Event NOT Approved Compliance Office Signature
Date
Please return Page 1 & 2 via e-mail to [email protected] or by fax at (316) 978-5330.
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NCAAA Bylaw 12.5.1.1 A member institution or recognized entity thereof (e.g., fraternity, sorority or student government organization), a member conference or a noninstitutional charitable, educational or nonprofit agency may use a student-athlete's name, picture or appearance to support its charitable or educational activities or to support activities considered incidental to the student-athlete's participation in intercollegiate athletics, provided the following conditions are met: (a) The student-athlete receives written approval to participate from the director of athletics (or his or her designee who may not be a coaching staff member) (b) The specific activity or project in which the student-athlete participates does not involve co-sponsorship, advertisement or promotion by a commercial agency other than through the reproduction of the sponsoring company's officially registered regular trademark or logo on printed materials such as pictures, posters or calendars. The company's emblem, name, address, telephone number and website address may be included with the trademark or logo. Personal names, messages and slogans (other than an officially registered trademark) are prohibited; (c) The name or picture of a student-athlete with remaining eligibility may not appear on an institution's printed promotional item (e.g., poster, calendar) that includes a reproduction of a product with which a commercial entity is associated if the commercial entity's officially registered regular trademark or logo also appears on the item; (d) The student-athlete does not miss class; (e) All moneys derived from the activity or project go directly to the member institution, member conference or the charitable, educational or nonprofit agency; (f) The student-athlete may accept actual and necessary expenses from the member institution, member conference or the charitable, educational or nonprofit agency related to participation in such activity; (g) The student-athlete's name, picture or appearance is not used to promote the commercial ventures of any nonprofit agency; (h) Any commercial items with names, likenesses or pictures of multiple student-athletes (other than highlight films or media guides per Bylaw 12.5.1.7) may be sold only at the member institution at which the studentathletes are enrolled, the institution's conference, institutionally controlled (owned and operated) outlets or outlets controlled by the charitable, educational or nonprofit organization (e.g., location of the charitable or educational organization, site of charitable event during the event). Items that include an individual studentathlete's name, picture or likeness (e.g., name on jersey, name or likeness on a bobble-head doll), other than informational items (e.g., media guide, schedule cards, institutional publications), may not be sold; and (i) The student-athlete and an authorized representative of the charitable, educational or nonprofit agency sign a release statement ensuring that the student-athlete's name, image or appearance is used in a manner consistent with the requirements of this section.
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