Academic Year 2018-19
Permission to Contact: Self-Release NCAA Division III
Name of institution you wish to contact:
Use this form so you may contact another NCAA Division III college or university's athletics staff members
(including coaches) about a possible transfer. This form does not allow you to contact athletics department
staff members at NCAA Division I or NCAA Division II institutions.
Bylaw states that:
"An athletics staff member or other representative of the institution's athletics interests shall not
make contact in any manner (e.g., in-person contact, telephone calls, electronic communication,
written correspondence) with the student-athlete of another NCAA or NAIA four-year collegiate
institution, directly or indirectly, without first obtaining written permission to do so, regardless of
who makes the initial contact. If permission is not granted, the second institution shall not
encourage the transfer. If permission is granted, all applicable NCAA recruiting rules apply.
Written permission may be granted by:
(a) The first institution's athletics director (or an athletics administrator designated by the
athletics director); or
(b) The student-athlete, if the student-athlete attends a Division III institution."
1. This form gives you permission to have contact with the athletics staff at another NCAA Division
III college or university to discuss a potential transfer. It also gives another college or university
permission to contact you. This form does not include any information about your academic or
athletics eligibility; however, in order to be immediately eligible to compete at the new institution,
you must not have an unfulfilled residence requirement and have been both academically and
athletically eligible for athletics had you stayed at your current institution.
2. This form is effective for 30 days from the date of signature. While the form is effective, the new
institution may contact you or you may contact the new institution. If this is the first time you have
sent this form to a particular institution, then that institution must preserve the privacy of this
contact and any further communication. If you desire, this privacy can be waived by checking the
Complete form, sign and send to the director of athletics at institution where you
wish to discuss a possible transfer.
Authorized by:
NCAA Division III Bylaw
To grant NCAA Division III student-athletes permission to contact other NCAA
Division III institution’s athletics department staff about a possible transfer.
Period of Release:
This permission to contact will be in effect for 30 days from the date this document
is signed.
Permission to Contact: Self-Release Division III
Page No. 2
box on Page No. 2 of this form. At the end of the 30-day period, if you decide to transfer, your
new institution must notify your current institution within a seven-day period of the form's
expiration date that this form was issued.
3. If you decide not to pursue the transfer, the new college or university is not allowed to notify
your current institution of the contact at any time. If you are undecided at the end of the
30-day period, you must send a new copy of this form to have additional contact with the college
or university. Further, because this second release is beyond the first 30-day period, the new college
or university must notify, within seven days, your current institution that a second release was
4. By signing this form, you agree that you permit the named college or university to contact you for
a 30-day period from the date this document is signed. You also agree that if you decide to transfer,
or if you send a second self-release, the new college or university will notify your current institution
of these facts. Institutions in receipt of this form are not allowed to notify your current institution
of this release, unless:
a. You have granted permission for that notification to occur by checking the box near the
end of this form;
b. You notify the institution in receipt of the form that you have decided to transfer to that
institution; or
c. You have issued a second self-release.
Signature of Student-Athlete Date
Name (please print) Name of current institution
Sport(s) of interest
Contact information (telephone number, email address, or physical address)
Check this box if this is the first release issued to this institution.
Check this box if you give the named college or university permission to notify your current
institution of this permission to contact during the 30 days this form is effective.
What to do with this form: Sign and send this form to the director of athletics at the college or university
you would like to contact about a possible transfer. You may send this form via facsimile, email or standard
mail, but the form must include a signature. If this form is emailed, it still must include a scanned signature.
This form is to be kept in the director of athletics' office for six years.