Junior High / Middle / Intermediate School Certificate Of Eligibility Form - Piaa
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1PENNSYLVANIA INTERSCHOLASTIC ATHLETIC ASSOCIATION, INC. (PIAA)
Junior High / Middle / Intermediate School Certificate of Eligibility
th
th
th
(7
, 8
and 9
Grade Competition Wherever Housed)
To the Principal of ________________________________________________________________________ School.
Complying with Article XVII and Article XIX, of the PIAA By‐Laws, I hereby certify that the following named students of:
_____________________________________ School are eligible to compete under all applicable provisions of the
Constitution, By‐Laws, Policies and Procedures, and Rules and Regulations of PIAA, with
_____________________________________ School in the Contest of ________________________________________
a.m.
(Name of Sport)
to be contested at ______________________________ beginning at _______ p.m. on ____________ the _______
(Location or Site)
(Time)
(Day)
(Date)
day of _________________, ________. I also certify that the following named students have been informed by myself,
(Month)
(Year)
or my designee, concerning PIAA’s Season and Out‐of‐Season Rules and Regulations as they apply to the
aforementioned sport. Grades included in school filing this form _____________.
(Identify Grades)
NUMBER OF
SEASONS OF COMPETITION
SEMESTERS
MINIMUM
TH
IN THIS SPORT BEYOND 6
PUBLIC SCHOOL DISTRICT
DATE OF
AGE ON
DATE OF ENROLLMENT
OCCURRING BEYOND
WRESTLING
GRADE INCLUDING PRESENT
LAST
TH
8
GR INCLUDING
NAME OF STUDENT
IN WHICH
BIRTH
FOR CURRENT SCHOOL
WEIGHT
SEASON
BIRTH‐
CURRENT SEMESTER
(MWW
)
YEAR
STUDENT RESIDES
MO/DAY/YR
DAY
HEAD COACH
MUST INITIAL
9
10
7
8
9
10
Signed__________________________________________, Principal ___________________________________________ School
Note: Make all Junior High/Middle/Intermediate School Certificates of Eligibility in duplicate. Retain original for the school’s files.
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