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Tue, Jul 22
Track & Field TBA
vs. IAAF World Junior Championships
IAAF World Junior Championships
Hayward Field
Wed, Aug 13
Soccer - W 5:00 PM
vs. Trinity Western (Exb.)
Exhibition Match
Eugene, Ore.
Fri, Aug 22
Soccer - W 7:00 PM
at Wisconsin
Wisconsin Tournament
Madison, Wis.
Sun, Aug 24
Soccer - W 12:00 PM
at UW-Milwaukee
Wisconsin Tournament
Madison, Wis.
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Service Request Form
If your school or organization would like to request the service of a student-athlete (SA), please submit the online Service Request form. Please note the following: Submitting a form does not guarantee the request will be fulfilled. Requests must be received at least two weeks prior to the date of activity. Requests for specific student-athletes or teams are not guaranteed.

Required Fields in Bold

 
Requester Information

First Name:
 
Last Name:
 
Phone:
 
E-mail:
 
 
Agency Information

Agency Name:
 
Agency Address:
 
Agency Phone:
 
Agency Mission:
 
 
Event Information

Event Date:
 
Event Time:
 
Times for Student-Athlete to Attend the Event:
 
Location of Event:
 
Description of Event:
 
Student-Athlete Responsibilities:
 
# of Student-Athletes Requested:
 
Sport of Student-Athlete Requested:
 
 
NCAA Compliance Questions

Your organization is (choose one):
 
Expenses being provided
Breakfast:
 
Yes
No
Lunch:
 
Yes
No
Dinner:
 
Yes
No
Overnight Lodging:
 
Yes
No
Mileage:
 
Yes
No
If YES, Total miles:
 
Other expense:
 
Yes
No
If YES, Please list:
 
Are funds being raised at this event?
 
Yes
No
If YES, What will the funds be used for?
 
Will any other agency aside from the requesting agency receive moneys from this appearance?
 
Yes
No
If YES, Please explain:
 
Will the appearance benefit individuals in 9th through 12th grade?
 
Yes
No
If YES, Please explain:
 
Will the Student-Athlete(s) appearance involve any athletics participation?
 
Yes
No
If YES, Please explain:
 
Is the event location a commercial establishment?
 
Yes
No
If YES, Please explain:
 
If YES, Will the commercial establishment be a co-sponsor, advertise or promote the event?
 
Yes
No
If YES, Please explain:
 
Will the Student-Athlete(s)' name, picture or appearance be used to promote any commercial ventures?
 
Yes
No
If YES, Please explain:
 
Will there be any outside organizations involved in this activity?
 
Yes
No
If YES, Please explain:
 
 
Will there be any advertisement or promotion of this event?
 
Yes
No
If YES, Please explain:
 
Will any promotional items bearing the name(s) or picture(s) of the Student-Athlete(s) be used?
 
Yes
No
If YES, Please explain:
 
 
Signature

I certify that all information listed above is accurate and that I am an authorized representative of the agency making the request. As the authorized representative, I certified that the student-athlete(s) name, image or appearance will be used in a manner consistent with the NCAA legislation outlined above.
Authorized Signature (please enter name):
 
Date: