Ncaa Certification Of Compliance (Appendix A) printable pdf download

Ncaa Certification Of Compliance (Appendix A)

Form 11-2

Academic Year 2011-12

Certification of Compliance for Staff

Members of Athletics Departments

NCAA member institutions.

For:

Action:

Complete and keep on file in the office of the director of athletics.

To be completed not later than September 15.

Due date:

Required by:

NCAA Bylaw 18.4.2.

To certify compliance with NCAA rules.

Purpose:

TO: RETURNING STAFF MEMBERS OF THE ATHLETICS DEPARTMENT

Name of your institution: _______________________________________________

Athletics department telephone: _______________________________________________

Division: _______________________________________________

Sign this form:



If you were a staff member of the athletics department (including part-time staff members,

graduate assistants and clerical staff) at this institution during the 2010-11 academic year and if

you are returning for the 2011-12 academic year.

Do not sign this form:



If you are a new employee for the 2011-12 academic year.

[Note:

Forms incomplete as of September 15 will result in loss of eligibility for NCAA

championships.]

Number of NCAA sports sponsored during the 2010-11 academic year: ___________________

By signing and dating this form, you certify that you have reported through the appropriate

individuals on your campus to your chancellor/president any knowledge of violations of NCAA

legislation involving your institution.

Name

Title

Signature

Date

(Print or type)

[include sport(s)]

M/D/Y

____________________

Director of athletics___

____________________

___/___/___

____________________

___/___/___

____________________

___/___/___

____________________

___/___/___

Ncaa Certification Of Compliance (Appendix A)

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