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METRO ATLANTIC ATHLETIC CONFERENCE

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DEPARTMENT OF ATHLETICS

METRO ATLANTIC ATHLETIC CONFERENCE

NCAA SPECIAL ASSISTANCE FUND

Application Form
Student-Athlete:_____________________; Sport:_______________; Pell:_____; Athletic Aid with Unmet Need:______
Institution:_________________________; Male:________ Female: ________; *International Student:_________
Conference: Metro Atlantic Athletic Conference
Purpose for which funds are requested:

AMOUNT

1. Medical Expenses (except those covered by another insurance policy),

including optional institutional medical insurance premiums.

2. Hearing Aid ________
3. Vision Therapy ________
4. Off-Campus Psychological counseling ________
5. Costs associated with student-athlete or family emergencies ________

(Include written description of emergency)

6. Purchase of expendable course supplies (e.g. notebook and pens) ________
7. Rental of non-expendable course supplies (e.g. computer equipment and cameras ________

that are required for all students enrolled in the course.)

8. $500 Allowance ________

Clothing ___________
Essentials __________
Transportation home from the institution __________

TOTAL AMOUNT: ________
If request includes money for clothing, shoes, or other essentials, please indicate the total amount the student-athlete has received during the current academic year: ____________________________________.
As the applicant, I verify that I am a PELL GRANT athlete who is participating on a varsity team or a student-athlete who is receiving countable athletically related financial aid and has demonstrated need as determined by the financial aid office.
Non-qualifiers may not receive special assistance funds during their first academic year in residence.
All SA’s who qualify for the fund, have access to all categories of the fund.
*For a foreign student-athlete, an official foreign student-athlete advisory entity of the institution outside the athletic department must certify in writing that the student-athlete has a financial need. Please send documentation to the conference office.
Student-Athlete Signature Date
Director of Athletics/Senior Women’s Administrator Date

NIAGARA UNIVERSITY

DEPARTMENT OF ATHLETICS

NOTICE OF ROSTER ADDITION

Sport:
Student’s Name:
ID#

Entering Status:	Freshman	Transfer: 2 year 4 year	Walk-on Year in school: ____________
Was the student-athlete recruited?	Yes	No
Has the student-athlete’s name been added to the IRL?	Yes	No
Coach’s signature: _____________________________	Date: _______________

NOTE: THIS STUDENT-ATHLETE IS NOT ELIGIBLE UNTIL YOU HAVE RECEIVED WRITTEN NOTICE FROM THE OFFICE OF COMPLIANCE!!

**Office Use Only**

Release form on file	Yes	No	N/A
Verified enrollment status:	Yes	No
Completed NCAA Student Athlete Statement	Yes	No
Completed NCAA Drug Testing Consent Form	Yes	No
Certified initial eligibility	Yes	No	N/A
Certified continuing eligibility	Yes	No	N/A
Student added to continuing eligibility squad list	Yes	No
Student added to the NCAA Compliance Software	Yes	No
Student added to ISQL activities table	Yes	No
SA’s financial aid information verified	Yes	No
Verified seasons of competition remaining: ___________	Yes	No
AAD - Compliance:_____________________________Date:_____________
Director of Athletics:___________________________Date:_____________
Notified coach in writing	Yes	No	Date:

Niagara University

Department of Athletics

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