For: Student-Athletes who will be or have been compensated for the use of their names, images, and likenesses for promotional purposes.
Action: Complete the form in its entirety and sign and return to Amanda Thatcher, Assistant AD for Compliance. This information will be kept on file in a manner consistent with federal and state law, if applicable.
Due Date: Prior to participation in NLI activities. Failure to disclose may impact the student-athletes' eligibility.
Complete one of the following payment choices:
By submitting this form, I acknowledge that my institution, or a designee of my institution, may review the accuracy of this information, and I consent to any investigation, review, or audit. I acknowledge that inaccurate or incomplete disclosure or failure to cooperate could support a reasonable conclusion that compensation I received constituted an inducement to attend or remain enrolled at a specific school, a substitute for pay for athletics performance or participation, or an otherwise illegitimate source of compensation for use of my name, image, and likeness.