Copyright @ National Letter of Intent - Made Fillable by eForms
Year 20___ / 20___
Name o
f Prospective Student-Athlete ___________________________________________________________________________
Last First Middle Initial
Perm
anent Address __________________________________________________________________________________________
City State Postal Code Country
Pros
pective Student-Athlete’s NCAA ID _____________________________ Date of Birth _____________________
(must be registered with the NCAA Eligibility Center and on the Institutional Request List)
Submission of this NLI has been authorized by:
SIGN
ED ______________________________________________ _____________________________________
Director of Athletics (or designee) Date Issued to Prospective Student-Athlete
For Institutional Use Only:
□ Two-year col
lege transfer
_____________
________________________________
□ 2-4 Qualifier □ 2-4 Nonqualifier
Sport □ Two-year college graduate Expected graduation date ____________
This
is to certify my decision to enroll at __________________________________________________________________________
Name of Institution
I certify that I have read all terms and conditions included in this document. I have discussed them with the coach and/or other staff
representatives of the institution named above, and I fully understand, accept and agree to be bound by them. I understand that signing this
NLI is voluntary and I am not required to sign the NLI to receive athletics aid and participate in intercollegiate athletics. Additionally, I give
my consent to the signing institution, to disclose to authorized representatives of its athletics conference (if any), the NCAA, the NCAA
Eligibility Center and the NLI Office any documents or information pertaining to my NLI signing. Further, I give my consent to the NLI
Office to disclose my name and personally identifiable information from my education records to a third party (including but not limited to
the media) as necessary to correct any inaccuracies reported by the media or related to my NLI signing, without such disclosure constituting
a violation of my rights, including my rights under the Family Educational Rights and Privacy Act.
If I falsify any part of this NLI, or if I have knowledge that my parent or legal guardian falsified any part of this NLI, I understand I shall
forfeit the first year of my athletics competition at any NLI participating institution.
My signature on this NLI nullifies any agreements, oral or otherwise, which would release me from the conditions stated within this NLI.
SIGNED _________________________________________ __________________ __________________
Prospective Student-Athlete Signature Signing Date (Mth/Day/Yr) Time (A.M. / P.M.)
Do not sign prior to 7:00 a.m.
(local time) on the initial
signing date.
Parent/ legal guardian signature is required if prospective student-athlete
has not reached his or her 21
st
birthday.
SIGNED __________________________________________ __________________ ___________________
□ Parent or □ Legal Guardian Signature Signing Date (Mth/Day/Yr) Time (A.M. / P.M.)
(check one) Do not sign prior to 7:00 a.m.
(local time) on the initial
signing date.
____________________________________ _____________________________
Print Name of Parent/Legal Guardian Telephone Number (including area code)
click to sign
signature
click to edit
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