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METRO ATLANTIC ATHLETIC CONFERENCE



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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 ________

  1. Clothing ___________

  2. Essentials __________

  3. 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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