Transfer Player Eligibility Statement

This page is to be filled out an ATHLETICS REPRESENTATIVE (assisted by the transfer student) only once at any NAIA institution. This form must be completed prior to participation for all students whose immediately previous identification with an institution of higher learning, even if the student has received an NAIA Eligibility Center determination for the current academic term. Complete all fields; if not applicable, write N/A in the field.

Institution *

State *

Email address *

Last Name *

First Name *

Middle Name

Eligibility Center ID *

Campus ID *

Date you first attended classes at this institution as a transfer student: *

Did you enroll after the date set by the institution for regular full-time students? *

Yes No

If "Yes", give date of enrollment:

Did you graduate from high school? *

Yes No

If "Yes", complete the following:

Month and year of high school graduation

High School Name

City, State, and Country

If "No" Did you earn a G.E.D.?

Yes No

list date G.E.D. earned

Have you served on Active Military Duty for one year or more? *

Yes No

List date of Discharge

Have you been granted a hardship/medical redshirt by any intercollegiate athletics association or conference? *

Yes No

If "Yes", complete the following:

Sport

Year

Granted By

Have you ever been suspended (or its equivalent) from any institution of higher learning? *

Yes No

Have you ever attended a four-year college or university, a trade school, a junior college or other post-high school institution? *

Yes No

If you answered "Yes" to the above question, complete the following two sections:

ATTENDANCE SECTION (account for every academic/calendar term since high school)

(1) Name of Institution (2) Type [2- or 4-year] (3) City (4) State (5) From MO/YR (6) To MO/YR (7) Number & Type of terms of attendance

COMPETITION SECTION

Did you participate in an intercollegiate contest at any previous institution?

Yes No

List below any seasons of competition in ALL intercollegiate sports

(1) Name of Institution (2) Seasons of competition* [List 1, 2, 3 or 4] (3) Sports (4) Year

RESIDENCY SECTION

I verify that I have confirmed or have been informed by my Athletics Director, who has confirmed that: *

Student previously participated at four-year institutions only Student previously participated at two-year institutions only Student previously participated at both four-year and two-year institutions Student previously participated at a four-year institution and has since graduated No previous participation No exceptions

Initial box to the right *

To the best of my knowledge, this is a complete and accurate report of my participation in college athletics. I believe I am eligible under NAIA rules. I understand withholding information or providing false information, particularly concerning previous institutional identification and/or participation, will rule me ineligible for participation in athletics within the NAIA.

* required field