NIL Disclosure

The State of Georgia Requires Disclosure of all Name, Image, Likeness Agreements to UGAAA

Student-Athlete Name*

First Last

Student-Athlete Sport*

Student-Athlete Year at UGA*

Student-Athlete Email Address*

Name of Business*

Name of your point of contact at the business*

First Last

Email for your point of contact at the business*

Phone number for your point of contact at the business*

Type of Endorsement*

If social media, please include the platform (twitter, instagram, tik tok, etc) and handle/account name

Method of Payment*

Total value*

*What is the total combined value of payment and/or product the business is paying you for your endorsement. (cash + Venmo + check + product value)

Written contractual agreement?

* If yes, please upload your written contractual agreement

Frequency*

*How often are you required to make an endorsement?

Does this agreement require you to endorse a product or service while engaging in official activities of the athletics program?*

Yes
No

(Ex. during a contest or while on call for competition, during practice, or during travel for competition)

If yes, please explain the details of the agreement

How was this agreement arranged?*

*Please select all that apply

Name of Agent

Email address of agent

Read and Confirm the Following Statements Required by Georgia State Law and /or UGAAA Policies

I have read and attest to the following:*

To the best of my knowledge, the University of Georgia, UGAAA, nor any entity whose purpose includes supporting or benefiting UGA or its athletic program provided payment or any other form of compensation for this agreement.

*

I did not miss class or a required academic appointment to fulfill this endorsement agreement.

*

I did not receive compensation to attend (initial and continued enrollment), participate, or perform at (or for) the University of Georgia.

NIL Disclosure

The State of Georgia Requires Disclosure of all Name, Image, Likeness Agreements to UGAAA

Read and Confirm the Following Statements Required by Georgia State Law and /or UGAAA Policies

Contact Us:

Follow Us on Twitter!

NIL Disclosure

NIL Disclosure

**The State of Georgia Requires Disclosure of all Name, Image, Likeness Agreements to UGAAA**

Read and Confirm the Following Statements Required by Georgia State Law and /or UGAAA Policies

Contact Us:

Follow Us on Twitter!

The State of Georgia Requires Disclosure of all Name, Image, Likeness Agreements to UGAAA