Student Athlete Employment Form

Student Athlete Employment Form
Business/Employer Name
Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Address
Address
Phone Number
Format: (000) 000-0000.
Telephone Number
Phone
Job Start Date

MonthDayYear
Job End Date

MonthDayYear
Job Title
Job Responsibilities/Duties
Job Responsibilities/Duties
How were you paid?
Hourly Rate
Salary
Commission Earned
Did anyone within the UT Athletic Department assist you in obtaining this job?
If yes, who?
How did you get to and from work?
Academic Year Employment
Student-Athlete Information
Name
Student ID Number
Sport
Verification
I certify that the above information is true, accurate, and complete to the best of my knowledge. Furthermore, I certify that I will notify theCompliance Office before the first contact with a student-athlete who has eligibility remaining in any sport and is enrolled at the University ofI have reviewed the Agent Policy, applicablelaw, and NCAA rules and regulations and have not engaged in any activity that would jeopardize the eligibility of any University ofstudent-athlete. I understand that failure to comply with the terms of this certification,law and the applicable NCAA legislation may result in the initiation of legal proceedings by the University ofagainst me and the assessment of civil and/or criminal penalties to me.
Student-athlete Email Address
Should be Empty:

Student-Athlete Information