NJCAA Letter of Intent Signee Information Form - Southeastern Community College

Email address *

Legal First Name of Student-Athlete *

Legal Last Name of Student-Athlete *

Preferred Last Name of Student-Athlete *

Date of Birth *

Student-Athlete Email Address *

Parents First and Last Name (Mother or Father, either one): *

Parent Email Address *

School Year of Scholarship agreement *

This student-athlete will be participating as a walk on: *

Yes No

This student-athlete will be participating as a scholarship recipient: *

Yes No

Will this student-athlete be participating in more than one sport at SCC? *

Yes No

Please select all sports this student-athlete will be participating in at SCC? *

Is this student-athlete a returner? *

Student-Athlete Signee Information

For Office Use Only _____ AAA Hold ______CRI Hold ________LOI FORM COMPLETED AND FILED

Please select the following for which sport you will be offering the scholarship *

Will the student-athlete be living on campus while attending SCC? *

Yes No

Gender *

Male Female

Name of High School Attended *

High School City and State *

Student-Athlete Home Address *

City/State / Province / Region *

Postal / Zip Code *

Country of Origin *

Is the student-athlete a U.S. Citizen? *

Yes No

Is the student-athlete from a foreign country? *

Yes No

NJCAA Season of Participation: *

Tuition Scholarship Awarded (Please enter Dollar Amount, Full or None and amount to be awarded by semester) *

Book Scholarship Awarded (Please enter dollar amount awarded, full or none and amount awarded by semester) *

Room and Board Scholarship Awarded (Please enter dollar amount awarded, full or none and amount by semester) Please Note: Room and Board Scholarship is only for Division I JUCO Sports (Men's Basketball and Softball) *

Additional notes that you would like indicated on Letter of Intent: *

Did signee graduate or will graduate from high school? *

Yes No

Anticipated Graduation Month and Year of High School *

Did signee take college coursework in high school? *

Yes No

Name of college/university where college coursework was taken in high school: *

Did signee transfer from another college/university in US, Puerto Rico or Canada? *

Yes No

If yes, Name of college/university transfered from:

Did student-athlete particpate in a sport during the regular season in intercollegiate athletics at the US, Puerto Rico, Canada institution they transferred from?

Yes No

Dates attended previous college/university

From:

Dates attended previous college/university

To:

Did student-athlete transfer from a foreign college/university? *

Yes No

If yes, name of foregin college/univeristy transferred from?

Did student-athlete particpate in a sport during the regular season in intercollegiate athletics at the foreign college/university they transferred from?

Yes No

Official college transcripts sent to SCC:

Yes No

Official high school transcripts sent to SCC:

Yes No

How would you (the coach requesting the LOI) like to receive the Letter of Intent back?

Scanned to your email Pick up in athletic office

Name of Coach Submitting Information

Current Date

* required field