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IAWP Affirmation
University of Georgia background review for IAWP Status
Candidate Name:
*
Candidate Email:
*
Title of Position Sought:
*
Sport:
*
Have you maintained contact or directed others to maintain contact (e.g., in-person, by telephone, written, electronically) with any athletes grade 9 or above in any of the following settings? (Check all that apply):
*
No
High School
4-year college
2-year college (JUCO)
Prep School
Non-Scholastic Team (7on7, Pop Warner)
Private Instruction (training center, private lessons)
Camp
Mentor
Any Other Setting Not Listed
If "Yes" to any of the above, please identify each individual (grade 9 and above) with which you have maintained contact or directed others to maintain contact related to athletics:
Describe the type and frequency of contact for each individual listed above:
Regarding the individuals listed above, was the contact with prospects related to the sport of football or basketball?
No Individuals Listed Above
Football
Basketball
Other Sport
Are you related to any athletes in grade 9 or above who are participating in or have participated in the sports of football or basketball at any of the following levels? (Check all that apply):
*
No
High School
Prep School
Non-Scholastic Organization (7on7, Pop Warner)
Junior College
Another four-year institution
If "Yes" to any of the choices above, please provide the name of the individual(s) and your relation to the individual(s).
Are the individuals listed in any of your responses above currently being recruited to attend the University of Georgia?
No Individuals Listed Above
Yes
No
Don't Know
If "Yes", which UGA sport is recruiting the individual(s)?
Have you ever maintained or directed others to maintain contact with any current University of Georgia football or basketball student-athletes prior to their enrollment at UGA?
*
No
Yes
If "Yes", please list the current student-athlete and describe the nature of your relationship.
Have you ever served as an event manager for athletic events involving teams from any of the following levels? (Check all that apply):
*
No
High School
Prep School
Non-scholastic (7on7, Pop Warner)
Junior College
Four-Year institution
If "Yes" above, please describe your role as an event manager and any ongoing contact you have had with the participants.
Have you ever been involved with or cited for a violation of an NCAA, conference or sport's governing body's (e.g., High School, College, Professional, National, International governing body) rules related to recruitment, academic misconduct, benefits to athletes, sports wagering, player eligibility, practice limits, or professional conduct?
*
No
Yes
If "Yes" above, please explain:
In signing below, I acknowledge that all the information provided on this form is accurate and that I understand that this information will be used to ensure compliance with NCAA rules.
Name
*
First
Middle
Last
Date
*
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