STUDENT-ATHLETE WITHDRAWAL FORM

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Please complete this form for all withdrawals from your official team roster. It is also the head coach's responsibility to deactivate the student-athlete from the team's FrontRush roster. If there are any questions, please notify your sport liaison or the Director of Athletics. Once this form is submitted, please consult with your sport liaison or the Director of Athletics, providing any additional documentation, as necessary, supporting the student-athlete's dismissal from the team.

STUDENT-ATHLETE (SA) FULL NAME:

SPORT: *

Did the SA receive athletic aid? *

Yes

Did the SA return all equipment? *

Yes

Please select one of the following: *

VOLUNTARILY WITHDRAW (Quit) from the team for personal reasons and, accordingly, his/her athletically related aid should be terminated immediately {bylaw 15.6.4.1 (d)}. Obtain your sport liaison/Athletic Director’s permission.

CUT/DISMISSED FROM TEAM- The student-athlete’s athletically related aid will be terminated at the end of the current academic year {bylaw 15.6.4.1}. Complete this form, and then obtain the Athletic Director’s permission.

CUT/DISMISSED FROM TEAM- The student-athlete has been suspended from school and/or team for disciplinary/academic reasons. Financial aid is canceled immediately {bylaw 15.6.4.1.1, 15.6.4.1.3}. The student-athlete will not be eligible for any exceptions to the one-year residence requirement for transfers {bylaw 14.5.1.2}. Complete this form, and then obtain the Athletic Director’s permission.

This student-athlete has been cut/dismissed from the team for the following reason(s): *

Do you grant permission for other NCAA institutions to contact this SA? *

Yes

SUBMITTED BY HEAD COACH: *

Submit

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