Athletic Tryout Form (Ncaa)
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4IPFW Athletic Department
TRYOUT FORM
Office of Athletic Compliance
I.
To Be Completed By Student‐Athlete
Name: ___________________________________________
Date: ____________________________
NCAA Eligibility Center ID #: __________________________
IPFW ID #: ________________________
Sport: ____________________________________________
Date of Birth: ______________________
Email: ____________________________________________
Phone #: __________________________
Permanent Address: _________________________________________________________________________
Campus Address: ___________________________________________________________________________
Emergency Contact Name: ____________________________
Relationship: _______________________
Emergency Contact Phone #: __________________________
Email: _____________________________
Semester/Year First Enrolled at IPFW:___________________
Year at IPFW: _______________________
Transfer Student?: YES NO If yes, please list the school(s) previously attended below.
Name of School(s) Previously Attended
Dates of Attendance
___________________________________________________
__________________________________
___________________________________________________
__________________________________
I certify that I am a full‐time student at IPFW (enrolled in at least 12 credit hours) and, to the best of knowledge, I
am in good health and physically fit for practice and competition. I agree to comply with all rules and regulations set
forth by IPFW, the Summit League and NCAA. I understand that I will not be allowed to practice until I have been
approved by each office in the clearance process.
Signature: __________________________________________
Date: ______________________________
*PLEASE COMPLETE THE FOLLOWING STEPS IN THE ORDER THEY ARE LISTED*
II.
To Be Completed by Head Coach
The student‐athlete named above will be given permission to practice/tryout with our team for a maximum of 14
days once all eligibility and physical requirements are properly documented. The student will not practice and/or
participate with the team until I have received notification from the Compliance Office that eligibility has been
granted. I will notify the Compliance Office at the end of the 14 day period whether the student‐athlete will join the
team or have no further affiliation with the team.
Start Date of Tryout: __________________________________
Recruited: YES NO
Head Coach Signature: _________________________________
Date: ______________________________
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