Student-Athlete Employment Verification Form
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1MSU OFFICE OF COMPLIANCE SERVICES
\
STUDENT-ATHLETE EMPLOYMENT VERIFICATION FORM
Student-Athlete:
Sport:
Is this student-athlete currently employed by your company/department?
Yes
No
Job Title:
_____________________________________________________
Employer:
Employer Phone:
______
Address:
City:
State & ZIP:
Date employment starts:
Date employment ends:
Hourly or weekly rate: $
Approximate hours of work per week:
Brief Description of job responsibilities:
Are you an alumnus or Booster of Michigan State University, or do you have any
Yes
No
other type of relationship with MSU?
If yes, please describe the relationship: ________________________________________________________
_________________________________________________________________________________________
Payment will be made by (Check all that apply):
Check
Cash
Tips
Other: ____________
By signing this statement, the employer agrees that:
The student-athlete will not receive any remuneration for the value or utility that the student-athlete
may have for the employer because of the publicity, reputation, fame or personal following he or she
has obtained because of athletics ability;
The student-athlete will be compensated only for work actually performed;
The student-athlete will be compensated at a rate commensurate with the going rate in that locality
for similar services and will not be given any benefits that are not provided to all employees;
The employer will make available for review and inspection/ by an authorized
representative at the NCAA, the Big Ten Conference, or Michigan State University, copies of all
documents, earnings statements and other records related to the employment of the student-athlete.
The employer will not use the appearance, name or picture of the student-athlete to promote his/her
product or service.
Printed Name of Employer
Signature of Employer
Date
Please return this form to:
Office of Compliance Services
or fax to: 517-432-5643
223 Kalamazoo Street, Room 223
East Lansing, MI 48824
EMPLOYMENT APPROVAL
Approved:
Yes
No
Office of Compliance Services_____________
____________________
Date____________
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