NJCAA Eligibility Affidavit

Sport: *

Today's Date: *

Personal Information:

First Name: *

Middle Name:

Last Name: *

Birth Date: *

SF ID Number:

Student's College Address: *

Email address *

Phone Number(s) at College:

Other Information:

Parent's Home Address:

Parent's Phone Number:

Parents' Names *

Foreign Born Students: Do you have an I-20 Form on file at this college?

Yes No

High School Information:

Name of High School(s) you have attended: *

City, State & Country: *

Did you graduate? *

High School Graduation Date:

Were you home schooled? *

Have you earned a GED or state department of education approved equivalency test? *

Yes No

If yes for the previous question, enter the date earned:

* Email chanda.stebbins@sfcollege.edu a COPY of your High School Transcript, and GED Certificate or state department of education approved high school equivalency test (if applicable).

Additional Information:

1. Did you take any college credit classes while in high school? *

Yes No

* If yes, from what college(s)?

* If yes, those transcript(s) from each college must be on file at this college.

2. Have you ever signed a Letter of Intent for with any institution? *

Yes No

* If yes, specify the College:

* If yes, provide the date signed:

3. Have you ever participated in a sport in a country other than the United States? *

Yes No

* If yes, describe the situation:

Provide sport(s), country, and dates

4. Have you ever been red-shirted for a season? *

Yes No

* If yes, list the dates of that season, name of college, and describe the situation.

5. Have you ever participated in practices, scrimmages, and/or games for an intercollegiate team other than this college? *

Yes No

* If yes, name the school, date, sport, and describe the situation.

6. Have you ever played on a club team at a college or university? *

Yes No

* If yes, name the?school, sport, and dates.

7. Do you currently play on any other sport teams (i.e. USAV, city recreational leagues, indoor soccer, AAU, etc.) *

Yes No

* If yes, please provide the name of team, location, and dates of participation.

8. Have you ever received money beyond expenses for participating in any athletic event? *

Yes No

Did anyone on your team receive money beyond expenses for participating in any athletic event?

Yes No

* If yes, describe the situation below and the NJCAA Amateurism Questionnaire should be completed and sent to chanda.stebbins@sfcollege.edu

List ALL Colleges Attended Full-Time and/or Part-Time after High School

All transcripts from all previous institutions must be sent to chanda.stebbins@sfcollege.edu

1. College, Dates, Full-Time/Part-Time

2. College, Dates, Full-Time/Part-Time

3. College, Dates, Full-Time/Part-Time

4. College, Dates, Full-Time/Part-Time

Additional Explanations:

NOTE: If you attended college part-time or were not attending college for any period of time following high school graduation, please document your employment and military history during those times in the space below. If you were unemployed at any time, please list those dates below. The NJCAA requires that you account for any time not enrolled full-time. Please record months and years when referring to any dates.

Provide all of this in the space below:

I understand that information falsified or omitted can make me ineligible for ALL future college competition in compliance with the National Junior College Athletic Association Eligibility Rules

By typing my name down below I am accepting the statement above *

* required field