NCAA SPECIAL ASSISTANCE FUND 2014-2015 INTERNATIONAL STUDENT-ATHLETE APPLICATION FORM

Student-Athlete: ______PID: ______E-mail Address: ______Sport: ______Local Address: ______Phone #: ______

I understand that I can utilize the NCAA Special Assistance Fund (SAF) for either clothing or reimbursement for travel from campus to home and back to campus. I understand that I cannot receive more than a combined total of $500 in this area.

_____ Clothing (up to $250 per semester) OR _____ Reimbursement for travel from campus to home (maximum of $500)

I further understand that I will not be eligible for the Special Assistance Fund in subsequent semesters if I fail to turn in receipts. Receipts must be submitted by the end of the semester in which the SAF is received. Receipts submitted after the deadline will not be accepted. Receipts should be signed and submitted in an envelope to the Office of Compliance Services.

______Student-Athlete Signature Date

Use of Office of Compliance Services Only

 PELL eligible per the Office of Financial Aid  International student-athlete with demonstrated financial need per Office of Financial Aid  Holds ______ F2014 Approved  S2015 Approved  Denied Comments: ______

______Office of Compliance Services Signature Date