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NJCAA Eligibility Affidavit
NJCAA Eligibility Affidavit
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This form verifies a student-athlete’s eligibility to compete under NJCAA rules at Vincennes University.
Title
A short description to explain the nature of a ticket.
NJCAA Eligibility Affidavit
Student Information
Are you a returning student athlete?
Are you a returning student athlete?
Yes
No
Choose sport(s)
Baseball
Mens Basketball
Womens Basketball
Mens Bowling
Cheer
Mens Cross Country
Womens Cross Country
Golf
Mens Track & Field
Womens Track & Field
Womens Volleyball
Clear
Full Name
List the first and last name of the student athlete.
A # / Student ID
Date of Birth
(mm/dd/yyyy)
Type the date of birth for the Student-Athlete.
Cell Number
Student-Athlete Cell Number
Address While At College
Email
Student-Athletes Email
Parental Information
Parent/Legal Guardian Full Name
Parent/Legal Guardian Address
Parent/Legal Guardian Phone Number
Foreign Born Students
Do you have an I-20 Form on file at this college?
Do you have an I-20 Form on file at this college?
Yes
No
High School Information
Name & Address of High School(s) you have attended:
Did you graduate?
Did you graduate?
Yes
No
Date graduated
(mm/dd/yyyy)
Month/Day/Year
Were you home schooled?
Were you home schooled?
Yes
No
Did you graduate?
Did you graduate?
Yes
No
Date graduated
(mm/dd/yyyy)
Did you earn a GED or state department of education approved high school equivalency test?
Did you earn a GED or state department of education approved high school equivalency test?
Yes
No
Additional Information
Date Earned
(mm/dd/yyyy)
Month/Day/Year
Did you take any college credit classes WHILE IN high school?
Did you take any college credit classes WHILE IN high school?
Yes
No
Transcript(s) from each college must be on file at VU
Names of colleges attended
Have you ever signed a Letter of Intent form with any institution?
Have you ever signed a Letter of Intent form with any institution?
Yes
No
Specify College Name(s) and Date(s)
Have you ever participated in a sport in a country other than the United States?
Have you ever participated in a sport in a country other than the United States?
Yes
No
List the sport(s), country, and dates of participation
Describe the situation
River Tam - Firefly Academy - Dance / Gymnastics
Have you ever been red-shirted for a season?
Have you ever been red-shirted for a season?
Yes
No
Describe the dates of that season, name of college, and describe the situation
Have you ever participated in practices, scrimmages, and/or games for an intercollegiate team other than this college?
Have you ever participated in practices, scrimmages, and/or games for an intercollegiate team other than this college?
Yes
No
List the school, date, sport, and describe the situation
Have you ever played on a club team at a college or university?
Have you ever played on a club team at a college or university?
Yes
No
List the school, sport and dates
Do you currently play on any other sport teams
USAV, city recreational leagues, indoor soccer, AAU, etc.
Do you currently play on any other sport teams
Yes
No
Please provide the name of team, location, and dates of participation
Have you ever received money beyond expenses for participating in any athletic event?
Have you ever received money beyond expenses for participating in any athletic event?
Yes
No
Describe the situation
Did anyone on your team receive money beyond expenses for participating in any athletic event?
Did anyone on your team receive money beyond expenses for participating in any athletic event?
Yes
No
Describe the situation
The NJCAA Amateurism Questionnaire must be completed.
https://vinu.teamdynamix.com/TDClient/69/Portal...
List all colleges and dates attended, whether it was Full-Time or Part-Time AFTER High School
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. The NJCAA requires that you account for any time not enrolled full-time. Please use the space below.
Please record months and years when referring to dates.
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.
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.
Yes
No
Acknowledgment & Consent
Clicking Submit signifies that you have thoroughly read and fully understand all the information presented in this form. This consent, waiver, indemnity and release is binding on me, my heirs, executors, administrators and assigns.This action is the equivalent of providing your handwritten signature and the current date.
Other Fields
Your name
Your first name
Your last name
Your email address
Verification Code