western kentucky university athletics compliance office

WESTERN KENTUCKY UNIVERSITY

ATHLETICS COMPLIANCE OFFICE

OFFICIAL VISIT APPROVAL FORM PROSPECT INFORMATION-COMPLETED BY COACH PROSPECT NAME :________________________ SPORT:__________________

NCAA ID #:_______________ DOB:__________________

PHONE NUMBER:________________

NAME OF SCHOOL:_____________________________________  HIGH SCHOOL/PREP SCHOOL  2-YEAR INSTITUTION  4-YEAR INSTITUTION VISIT INFORMATION -COMPLETED BY COACH DATE/TIME VISIT BEGINS:___________________

EMAIL:_________________________

CITY/STATE :___________________

DATE/TIME VISIT ENDS:_________________

INDIVIDUALS ACCOMPANYING PROSPECT:

RELATIONSHIP:

ACCOMODATIONS:  HOTEL – NAME _____________________________  ON CAMPUS TRANSPORTATION:  AIR FLIGHT ARRIVAL DATE /TIME:__________________ FLIGHT DEPARTURE DATE/TIME :__________________  AUTOMOBILE  OTHER________________ STUDENT HOST:

 YES

 NO

IF YES, NAME :____________________

AMOUNT (MAX $40/DAY ):_______

___ ___________________________ HEAD COACH’S SIGNATURE

_______________________ DATE

FOR COMPLIANCE OFFICE USE HIGH SCHOOL/COLLEGE TRANSCRIPT RECEIVED :  YES  NO TEST SCORE RECEIVED:  YES SCORE________  NO  N/A

PSA ON IRL:  YES  NO ITINERARY ATTACHED:  YES  NO

APPROVAL OF ATHLETICS COMPLIANCE OFFICE

4-YEAR PERMISSION TO CONTACT:  YES  NO  N/A VISIT APPROVED:  YES  NO

DATE