NATIONAL COLLEGIATE WRESTLING ASSOCIATION -- NCWA
NATIONAL COLLEGIATE WRESTLING ASSOCIATION 2016-17 SEASON NEW TEAM MEMBERSHIP APPLICATION & INVOICE WOMEN’S DIVISION Membership New Team Fee -- $ 465.00
(Fee is for teams without a Men’s Division program) New Membership Fee Due between: April 15th - December 31st - amount due $465 Late Fee: January 1st -- add $100 ............................................................................ amount due $565 No New Memberships accepted after February 1, 2017
Step # 1 -- Complete this Application using computer, print form and have it signed as indicated Step # 2 -- Scan & Upload this signed application showing administrative signature approval to: [email protected] Step # 3 -- Select payment method: Online by credit card / debit card
Check to be mailed with copy of form (Payable: NCWA – Mail to: 8737 Grenadier Dr – Dallas, TX 75238-3819
MEMBERSHIP INFORMATION: (enter data using computer - be sure ‘insert’ feature is active)
School's Full Name:.. _____________________________________________________________________________ School’s Physical Address: __________________________________________________________________________ City: _________________________________________ State: ___________ Activities Coordinator of School: ______________________________ Coordinator’s Title: _______________________________________ Office Phone: (_____) _____________________ Compliance Officer: _______________________________________
Zip+4: ______________________
email: ______________________________ Cell Phone: (_____) ___________________ Phone: (_____) _____________________
Compliance Officer’s e-mail: _________________________________ Head Wrestling Coach: ______________________________________
Phone: (_____) _____________________
Coach's e-mail:____________________________________________
Cell Phone: (_____) _________________
Wrestling Team President: ___________________________________
Cell Phone: (______) _________________
Team President’s e-mail: ____________________________________ Cell Phone: (______) ________________ Team Sports Information Director: _____________________________ Phone: (_____) ____________________ SID’s Email: ________________________________________________ School’s Website: _______________________________________ Wrestling Team’s Website: ____________________ School’s Mascot: ____________________________ School’s Colors: ________________________________________ Membership in the NCWA implies that the applying school will abide by all rules and regulations as set forth in the currently published NCWA Wrestling Plan, which may include, but are not limited by, NCAA applicable rules. Your Signature on this application signifies that the wrestling team is an officially recognized activity at your institution and that the applying school officials listed below have read, and will comply with, the rules as set forth by the NCWA including the rules of competition and Code of Ethics within the National Collegiate Wrestling Association. The currently published NCWA Wrestling Plan can be found on: www.ncwa.net
Activities Coordinator must be a school employee responsible for the oversight authority of the wrestling program. All Signatures below must correspond to the names submitted above – All signatures must be real – not digital
Activities Coordinator’s Signature: ________________________________ Date: ___________ Compliance Officer’s Signature: __________________________________ Date: ___________ Team Coach’s Signature: _______________________________________ Date: ___________ Team President’s Signature:
____________________________________ Date: ___________ © - NCWA – 9/15/16
(Fee is for teams without a Men’s Division program) New Membership Fee Due between: April 15th - December 31st - amount due $465 Late Fee: January 1st -- add $100 ............................................................................ amount due $565 No New Memberships accepted after February 1, 2017
Step # 1 -- Complete this Application using computer, print form and have it signed as indicated Step # 2 -- Scan & Upload this signed application showing administrative signature approval to: [email protected] Step # 3 -- Select payment method: Online by credit card / debit card
Check to be mailed with copy of form (Payable: NCWA – Mail to: 8737 Grenadier Dr – Dallas, TX 75238-3819
MEMBERSHIP INFORMATION: (enter data using computer - be sure ‘insert’ feature is active)
School's Full Name:.. _____________________________________________________________________________ School’s Physical Address: __________________________________________________________________________ City: _________________________________________ State: ___________ Activities Coordinator of School: ______________________________ Coordinator’s Title: _______________________________________ Office Phone: (_____) _____________________ Compliance Officer: _______________________________________
Zip+4: ______________________
email: ______________________________ Cell Phone: (_____) ___________________ Phone: (_____) _____________________
Compliance Officer’s e-mail: _________________________________ Head Wrestling Coach: ______________________________________
Phone: (_____) _____________________
Coach's e-mail:____________________________________________
Cell Phone: (_____) _________________
Wrestling Team President: ___________________________________
Cell Phone: (______) _________________
Team President’s e-mail: ____________________________________ Cell Phone: (______) ________________ Team Sports Information Director: _____________________________ Phone: (_____) ____________________ SID’s Email: ________________________________________________ School’s Website: _______________________________________ Wrestling Team’s Website: ____________________ School’s Mascot: ____________________________ School’s Colors: ________________________________________ Membership in the NCWA implies that the applying school will abide by all rules and regulations as set forth in the currently published NCWA Wrestling Plan, which may include, but are not limited by, NCAA applicable rules. Your Signature on this application signifies that the wrestling team is an officially recognized activity at your institution and that the applying school officials listed below have read, and will comply with, the rules as set forth by the NCWA including the rules of competition and Code of Ethics within the National Collegiate Wrestling Association. The currently published NCWA Wrestling Plan can be found on: www.ncwa.net
Activities Coordinator must be a school employee responsible for the oversight authority of the wrestling program. All Signatures below must correspond to the names submitted above – All signatures must be real – not digital
Activities Coordinator’s Signature: ________________________________ Date: ___________ Compliance Officer’s Signature: __________________________________ Date: ___________ Team Coach’s Signature: _______________________________________ Date: ___________ Team President’s Signature:
____________________________________ Date: ___________ © - NCWA – 9/15/16
