SQUAD CHANGE REQUEST FORM
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SQUAD CHANGE REQUEST FORM Eastern Kentucky University Intercollegiate Athletics Student-Athlete Name:
EKU ID#:
Date of Form Completion:
Sport:
Requested Squad Change: Date Associated with Requested Change: Added Student-Athlete Information: (Only complete this section if you are adding a student-athlete) NCAA Eligibility Center ID #: Recruited:
Yes
No
Qualification Status: Amateurism Status: 1st Term of Enrollment at EKU:
Year:
1st Term of Enrollment at Any Institution:
Year:
Terms of Previous Competition: Fall
Spring
Fall
Spring
Fall
Spring
Fall
Spring
Transfer:
Yes
No
If yes, list previous institutions and dates of attendance:
Institution
Dates of Attendance
Approvals Print Head Coach Name
Head Coach Signature
Print Sport Administrator Name
Date
Sport Administrator Signature
Date
Voluntary Scholarship Release: (Only complete this section if the student-athlete is on scholarship.) My signature indicates that I voluntarily withdraw from the team and release EKU from its obligation to provide me with athletics-related financial aid for the following term(s) of the current academic year: Fall Spring Furthermore, I understand that I am responsible for the remained of my educational costs. Signature:
Date: Student-Athlete
Distribution:
Sport Administrator, Compliance Office, Athletics Director’s Assistant (scholarship office), Registrar’s Office, Bratzke Center, Sports Medicine, Athletics Public Relations
Submit by E-mail
SQUAD CHANGE REQUEST FORM Eastern Kentucky University Intercollegiate Athletics Student-Athlete Name:
EKU ID#:
Date of Form Completion:
Sport:
Requested Squad Change: Date Associated with Requested Change: Added Student-Athlete Information: (Only complete this section if you are adding a student-athlete) NCAA Eligibility Center ID #: Recruited:
Yes
No
Qualification Status: Amateurism Status: 1st Term of Enrollment at EKU:
Year:
1st Term of Enrollment at Any Institution:
Year:
Terms of Previous Competition: Fall
Spring
Fall
Spring
Fall
Spring
Fall
Spring
Transfer:
Yes
No
If yes, list previous institutions and dates of attendance:
Institution
Dates of Attendance
Approvals Print Head Coach Name
Head Coach Signature
Print Sport Administrator Name
Date
Sport Administrator Signature
Date
Voluntary Scholarship Release: (Only complete this section if the student-athlete is on scholarship.) My signature indicates that I voluntarily withdraw from the team and release EKU from its obligation to provide me with athletics-related financial aid for the following term(s) of the current academic year: Fall Spring Furthermore, I understand that I am responsible for the remained of my educational costs. Signature:
Date: Student-Athlete
Distribution:
Sport Administrator, Compliance Office, Athletics Director’s Assistant (scholarship office), Registrar’s Office, Bratzke Center, Sports Medicine, Athletics Public Relations
