Athletics Grant In Aid Request Form
	     				     		 Full Grant    Partial Grant
		Sport	Academic Year		Date of Birth	(required for NLI) 

	     			     		Original 	New Student 	National Letter of Intent 
		Name (including middle initial)			Social Security Number		Renewal 	Freshman 	(Need middle name or initial, DOB & SS#)
		(required for NLI)		Revision 	Transfer 
	     				5th Year Student 
		Street Address

	     	     	     	
	City	ST	Zip

1.	This award begins 		and ends 	
2.	If this award is a FULL GRANT check the appropriate boxes regarding how the grant is to be paid, the remainder will be divided into 9 monthly stipends.  If this award is a PARTIAL GRANT check the appropriate boxes or fill in exact dollar amounts including the total grant amount. 
	
	Fees and Tuition	Other
	Fall Fees  $     	Books  $     
	
	Spring Fees $     	Housing  $     
	
	Summer School/Intercession Fees $     	Meals  $     
	
	Non-resident Fees  $         Number of NR units if more than 12($282 each unit)

	Monthly Awards

	September $     	October $     	November $     

	December $     	January $     	February $     

	March $     	April $     	May $     

Total Grant Amount $