Eastern Illinois University
Athletic Compliance Office
TEAM ROSTER ADDITION FORM
Submitted by: ____________________
I.
Sport: ____________________
Date: ___________________
ROSTER ADDITION
STUDENT-ATHLETE NAME:
E NUMBER#:
PHONE NUMBER:
EMAIL:
Head Coach Signature
II.
_______
Date
COMPLIANCE OFFICE
Compliance Department
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
To be completed prior to clearance for participation
Admitted to EIU, Enrolled in 12 hours
NCAA Eligibility Center—Academic
NCAA Eligibility Center—Amateurism
EIU Compliance Paperwork
Transfer Status
Transfer Release
A.A. Degree earned from previous 2-year institution
A.A. Degree on file at EIU
Recruiting Status per Bylaw 15
Drug Testing Consent Form
_________________________________
No
Non-Qualifier
Not Certified
No
4-4
No
No
No
Non Recruited
No
No Decision
No Decision
4-2-4
N/A
N/A
____________________________________
COMPLIANCE SIGNATURE
III.
Yes
Qualifier
Certified
Yes
2-4
Yes
Yes
Yes
Recruited
Yes
DATE
ATHLETIC TRAINING OFFICE
Athletic Training Department
1.
2.
3.
4.
5.
6.
7.
8.
To be completed prior to clearance for participation
Pre-Participation Physical
Sickle Cell
Proof of Insurance/Copy of Insurance Card
Parent Info Form
HIPPA Form
NexTT
Impact Test (contact sports only)
Injury Accountability Agreement Form
___________________________________
HEAD ATHLETIC TRAINER’S SIGNATURE
Complete
In-complete/pending
___________________________________
DATE
Athletic Trainer—Please have Student-Athlete return form to Compliance Office
IV.
(COMPLIANCE OFFICE ONLY)
DATE RECEIVED: _________
DIRECTOR FOR COMPLIANCE
_______
CAi: _________
DATE
Email List: Sport Administrator, Financial Aid, Registrar’s Office, Academics, Sports Medicine, Strength and Conditioning Sports
Information, Insurance, Foundation (If necessary)