No Yes No Yes No Yes

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May 30, 2017 - Name of Contact Person. Phone Number. Address: (Street, City, State, Zip) ... The University of Akron. Compliance Office for Athletics. Donation ...

The University of Akron

Donation Request

Compliance Office for Athletics

This form, when signed by the promotional agency involved and approved by the Athletic Department, allows athletic staff members or student-athletes to autograph memorabilia for institutional, charitable or other educational agencies, events or to donate tickets. NCAA Bylaws 12.5 Promotional Activities; 12.5.1 Permissible; 12.5.2 Nonpermissible

Name of Sponsoring Agency: Agency Description (check one):



Institutional



Charitable



Type of Request: Educational

Proof of 501(c)(3) status may be required.

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Other Request: Ticket Request:

Sport Involved:

Name of Contact Person

Date of Competition:

Phone Number

Address: (Street, City, State, Zip) Date of Event:

Time of Event:

Site and City of Event:

Please describe your event:

NCAA regulations preclude its remembers from participating in or providing memorabilia for fund-raising activities that either directly or indirectly benefit any student who has started the ninth grade.

□ □ □

No

□ □

No



No

Yes

1. Is this a fund-raising event?

Yes

2. Will the funds raised from the event directly or indirectly benefit prospects? If yes, UA or its representatives may not participate in the event. If no, explain the use of funds or tickets:

Yes

3. Will the event involve students who have started the ninth grade?

Please provide any additional information that is applicable:

I certify that the donations or tickets will not be used to benefit any person that is prospect age. Approved? Number of Tickets? Date: Signature of Person Making Request: Date: Signature of Asst. AD for Compliance

Date:

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