Indiana State University Athletics
Indiana State University Athletics
Student Athlete Voluntary Withdrawal Form
I, hereby voluntarily withdraw from participation in the sport of at Indiana State University. No person has asked, pressured or coerced me into executing this document and my withdrawal from this sport is entirely my own decision and is in my best interests. I acknowledge that by taking this action, I forfeit all rights to any athletic financial aid I may be entitled to from the date hereof for the current academic year, UNLESS MY COACH AND I AGREE OTHERWISE. Further, I understand that I will not be eligible to receive any such athletic financial aid in future periods of enrollment unless it is so awarded by the head coach. I hereby release Indiana State University from any and all obligations for such financial assistance. I understand that is my responsibility to officially withdraw from the sport and weight training classes if they appear on my class schedule. If I do not officially withdraw through the procedures established for all Indiana State University students, I understand that my grade for those classes will result in a failing or incomplete grade. Additionally, I hereby waive any and all rights to receive any notice of the cancellation of my athletic scholarship from the athletic department or the financial aid office of Indiana State University that may be required by NCAA, Missouri Valley Conference regulations, and hereby release said entities from any requirement thereof. Student-Athlete Signature
Date
Compliance Signature
Date
Print Form RETURN COMPLETED AND SIGNED FORM TO: JOEL MCMULLEN, ASSISTANT ATHLETIC DIRECTOR FAX: 812-237-4041 or email [email protected] or by mail at ISU Athletics Arena, Room 104E, Terre Haute, IN 47809
Distribution:
Original-SA file Copies: Coach, FinAid, FAR, SWA, Sue Ralston, Acad Services ROSTER CHANGE FORM FROM COACH? ___
INPUT - CA? ____
Student Athlete Voluntary Withdrawal Form
I, hereby voluntarily withdraw from participation in the sport of at Indiana State University. No person has asked, pressured or coerced me into executing this document and my withdrawal from this sport is entirely my own decision and is in my best interests. I acknowledge that by taking this action, I forfeit all rights to any athletic financial aid I may be entitled to from the date hereof for the current academic year, UNLESS MY COACH AND I AGREE OTHERWISE. Further, I understand that I will not be eligible to receive any such athletic financial aid in future periods of enrollment unless it is so awarded by the head coach. I hereby release Indiana State University from any and all obligations for such financial assistance. I understand that is my responsibility to officially withdraw from the sport and weight training classes if they appear on my class schedule. If I do not officially withdraw through the procedures established for all Indiana State University students, I understand that my grade for those classes will result in a failing or incomplete grade. Additionally, I hereby waive any and all rights to receive any notice of the cancellation of my athletic scholarship from the athletic department or the financial aid office of Indiana State University that may be required by NCAA, Missouri Valley Conference regulations, and hereby release said entities from any requirement thereof. Student-Athlete Signature
Date
Compliance Signature
Date
Print Form RETURN COMPLETED AND SIGNED FORM TO: JOEL MCMULLEN, ASSISTANT ATHLETIC DIRECTOR FAX: 812-237-4041 or email [email protected] or by mail at ISU Athletics Arena, Room 104E, Terre Haute, IN 47809
Distribution:
Original-SA file Copies: Coach, FinAid, FAR, SWA, Sue Ralston, Acad Services ROSTER CHANGE FORM FROM COACH? ___
INPUT - CA? ____
