NCISAA Foreign and/or Exchange Student Information
for NCISAA Athletic Participation
2008 - 2009
 

School Name:  ____________________________________________

Athletic Director:  ____________________________  Telephone:  _____________________________

Head of School:  _____________________________  Telephone:  _____________________________

Note:  If no exchange or foreign students will participate in NCISAA competition, please indicate same by checking this box

and signing below. 

Student's Name:  _____________________________________________________________________
                                 Last                                        First                                         MI

Date of Birth:  _____________________________  Grade:  ________________________

Country of Birth:  __________________________  Country of Citizenship:  __________________________

Type of Visa issued by Immigration and Naturalization Service:  _________________________

Note:  If student has not entered school via a credentialed exchange agency, attach a separate letter of explanation.

List sports in which student may/will participate:

• _______________________________

• _______________________________

• _______________________________

• _______________________________

Does student receive any need-based financial aid?  ___________

Does student receive any scholarship assistance based on merit?  ___________

Does the student live with a host family?  ________________

• Name of family:  __________________________

• Relationship to school:  _______________________________________

• Telephone:  ____________________________

I hereby attest that the above information is accurate and the above named student is enrolled at ___________________________ as a full time student meeting all eligibility requirements of the most current policies of the NCISAA.

________________________________________________
Athletic Director's Signature

________________________________________________
Head of School's Signature

_________________________
Date

Please return this form to the NCISAA office along with your annual membership fees and information and financial aid statement.

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