SCHOLARSHIP REDUCTION, CANCELLATION OR
SCHOLARSHIP REDUCTION, CANCELLATION OR NON-RENEWAL REQUEST FORM Please allow at least 5 business days to process ______ Reduction
______ Cancellation
______ Non-Renewal for 20____-20____ Academic Year
Sport: ________________________________________ Date: _____________________________________________
Name (First, Middle, Last):________________________________________Student ID Number: _________________ Permanent Address: ___________________________________________Email Address:________________________ Home Phone: _______________________________
Cell Phone: ________________________________________
Mailing Address for Non-Renewal, Reduction or Cancellation Letter (Provide only if different from above address):_________________________________________________________________________________________ Reason for: _______ Reduction _______ Cancellation _______ Non-Renewal ______ Student-athlete exhausted his/her athletics eligibility ______ Student-athlete is graduating from UH Hilo Fall_____ Spring _____ ______ Student-athlete is transferring to another institution ______ Student-athlete voluntarily withdrew from the team at any time for personal reasons Date student-athlete quit ____________________ Date of roster status change_________________ ______ Student-athlete was (Check one) _____ Cut from team _____ Dismissed from the team: Date student-athlete cut/dismiss_______________ Date of roster status change ________________ ______ Student-athlete failed to comply with academic policies and standards and is academically ineligible per NCAA and/or UH Hilo requirements ______ Student-athlete rendered himself or herself ineligible for intercollegiate competition ______ Student-athlete failed to comply with team rules/policies, athletics department policies or institutional policies ______ Student-athlete fraudulently misrepresents any information on an application, letter of intent or financial aid agreement ______ Student-athlete engaged in serious misconduct warranting substantial disciplinary penalty (see Bylaw 15.6.4.1.3) ______ Student-athlete engaged in misconduct by the university’s regular student disciplinary authority. ______ Student-athlete signed a professional sports contract ______Other. Please explain in detail_________________________________________________________________ _________________________________________________________________________________________ **Attach any disciplinary forms, transcripts, medical records, correspondence, etc. Signatures: Head Coach: __________________________________________ Date: ____________ Approved_____Denied_____ Sport Supervisor: ______________________________________ Date: ____________ Approved_____ Denied_____ Compliance Officer/SWA: _______________________________ Date: ____________ Approved_____ Denied_____ Director of Athletics: ___________________________________ Date: ____________ Approved _____ Denied_____
_____ Coach Informed Student-Athlete of Reduction, Cancellation or Non-Renewal on ______________ Initials _____ _____ Notice of Reduction, Cancellation or Non-Renewal Emailed to Financial Aid Office on _________Initials _____ _____ Notice of Reduction, Cancellation or Non-Renewal and Appeal Policy and Procedures sent to student-athlete by Financial Aid Office; sent by _______________________on ________ Initials _____ _____ (Financial Aid Office) Notify Admissions to Cancel Exemption Date: ________________Initials____________ _____ (Admissions Office) Processed removal of exemption code Date: ________________Initials____________
______ Cancellation
______ Non-Renewal for 20____-20____ Academic Year
Sport: ________________________________________ Date: _____________________________________________
Name (First, Middle, Last):________________________________________Student ID Number: _________________ Permanent Address: ___________________________________________Email Address:________________________ Home Phone: _______________________________
Cell Phone: ________________________________________
Mailing Address for Non-Renewal, Reduction or Cancellation Letter (Provide only if different from above address):_________________________________________________________________________________________ Reason for: _______ Reduction _______ Cancellation _______ Non-Renewal ______ Student-athlete exhausted his/her athletics eligibility ______ Student-athlete is graduating from UH Hilo Fall_____ Spring _____ ______ Student-athlete is transferring to another institution ______ Student-athlete voluntarily withdrew from the team at any time for personal reasons Date student-athlete quit ____________________ Date of roster status change_________________ ______ Student-athlete was (Check one) _____ Cut from team _____ Dismissed from the team: Date student-athlete cut/dismiss_______________ Date of roster status change ________________ ______ Student-athlete failed to comply with academic policies and standards and is academically ineligible per NCAA and/or UH Hilo requirements ______ Student-athlete rendered himself or herself ineligible for intercollegiate competition ______ Student-athlete failed to comply with team rules/policies, athletics department policies or institutional policies ______ Student-athlete fraudulently misrepresents any information on an application, letter of intent or financial aid agreement ______ Student-athlete engaged in serious misconduct warranting substantial disciplinary penalty (see Bylaw 15.6.4.1.3) ______ Student-athlete engaged in misconduct by the university’s regular student disciplinary authority. ______ Student-athlete signed a professional sports contract ______Other. Please explain in detail_________________________________________________________________ _________________________________________________________________________________________ **Attach any disciplinary forms, transcripts, medical records, correspondence, etc. Signatures: Head Coach: __________________________________________ Date: ____________ Approved_____Denied_____ Sport Supervisor: ______________________________________ Date: ____________ Approved_____ Denied_____ Compliance Officer/SWA: _______________________________ Date: ____________ Approved_____ Denied_____ Director of Athletics: ___________________________________ Date: ____________ Approved _____ Denied_____
_____ Coach Informed Student-Athlete of Reduction, Cancellation or Non-Renewal on ______________ Initials _____ _____ Notice of Reduction, Cancellation or Non-Renewal Emailed to Financial Aid Office on _________Initials _____ _____ Notice of Reduction, Cancellation or Non-Renewal and Appeal Policy and Procedures sent to student-athlete by Financial Aid Office; sent by _______________________on ________ Initials _____ _____ (Financial Aid Office) Notify Admissions to Cancel Exemption Date: ________________Initials____________ _____ (Admissions Office) Processed removal of exemption code Date: ________________Initials____________
