Texas Tech University – Intercollegiate Athletics
4­Year Institution ­ Tracer Form
NCAA Bylaw 14.5.5

NAME:
INSTITUTION:

SPORT:

To help certify this student’s eligibility please complete the following:
1. Is or was the student listed above a student­athlete at your institution?

  YES      

  NO

(IF YES, COMPLETE ENTIRE FORM; IF NO COMPLETE QUESTIONS 2­7)

If YES, what sport(s)? _________________________________________________________________________________
Does your institution sponsor this/these sport(s)?  (per NCAA Bylaw 14.5.5.2.6)        YES         NO
2.

Do you grant Texas Tech permission to contact this student?  (Per NCAA Bylaw 13.1.1.3)    

3.

Dates student attended your institution:                   to                      Number of full­time semesters/quarters attended: _______
 Did the student withdraw from your institution?    

4.

5.

 YES   

 NO       N/A

         (excluding summer sessions)

  YES      

  NO

 If YES, what was the official withdrawal date? _________________
Did student transfer to your institution?        YES   
  NO

 If yes, please list previous institution(s) _________________________________________   2 year ______    4 year _______
Would this student have been eligible had they remained at your institution?  

  YES    

  NO

(This includes NCAA Bylaw 14.4.3.1 (c) ­ 6 Hr. Rule & NCAA Bylaw 14.5.5.4)

 If no, please explain why: __________________________________________________________________________

8.

Was the student in good academic standing at your institution?  (Per NCAA Bylaw 14.5.5.2.10­c)
  YES      NO
Was the student disqualified or suspended from your institution for disciplinary reasons (as opposed to academic reasons)?  (Per 
NCAA Bylaw 14.5.1.2)           YES       NO
Did this student­athlete sign a National Letter of Intent to attend your university?
  YES       NO

9.

 Did the student­athlete fulfill his/her obligation under the terms of the NLI?               YES         NO
Has a Complete Release been given to student?       YES       NO       NA    (If yes, please attach a copy)
Please complete the following chart: If track and field, please distinguish indoor/outdoor and cross country

6.
7.

Bryan Principe, Initial Eligibility Coordinator • bryan.principe@ttu.edu • Phone (806) 834-3101• Fax (806) 742-0575
Athletic Academic Services • Texas Tech University • Box 42181 • Lubbock, TX 79409-2181

 Sport

Academic Year/Term

Practiced
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO

10. Years of eligibility used at your institution:       

  0          

Competed
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO

  1         

  2          

  3         

  4 

11. Did the student­athlete practice more than 14 consecutive days?  (Per NCAA Bylaw 14.5.5.2.7)     
12. Did the student­athlete receive a hardship waiver or any other exception?     

  YES    

Athletic Aid
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO

  YES     

  NO

  NO

 Name the Waiver/Exception(s) ____________________________________________________________________________
 List the Year(s) Received  
________________________________________________________________________________
13. What was the student­athlete’s status with the NCAA Eligibility Center?     Qualifier       Non­Qualifier
14. Was the student­athlete recruited by your institution?  (Per NCAA Bylaws 14.5.5.2.10.2  & 13.02.12.1)        YES        
15.   Membership level of your institution:

  NCAA Division ____

    

  Unknown
  NO  

  NAIA

16. Do you have any objections to this student being granted the one time transfer exception?  (Per NCAA Bylaw 14.5.5.2.10)                   
  YES           NO           NA
 
              
               
 
               
 
               
 
               
 
               
 Signature of Person Completing Form

 
              
               
 
               
 
               
Title

 
              
               
 
        
          
Date

 
              
               
 
               
 
               
 
               
 
               
 
              
               
 
               
 
 ___________________________________
 Print Name
                                          Phone Number and E­Mail Address

Bryan Principe, Initial Eligibility Coordinator • bryan.principe@ttu.edu • Phone (806) 834-3101• Fax (806) 742-0575
Athletic Academic Services • Texas Tech University • Box 42181 • Lubbock, TX 79409-2181