CALIFORNIA STATE UNIVERSITY, FULLERTON
Requests Permission To Speak To Prospective Transfer

1.	Student's Name		
Address		

Telephone		
2.	Student's Sport		
3.	Transferring from		
	Address		

	Phone		
	FAX		
4.	Does California State University, Fullerton have permission to speak to this student?	 Yes	 No
5.	If permission is not granted, has the student-athlete been informed in writing, according to bylaw 13.1.1.3.1 of his/her right to a hearing?	 Yes	 No

Name			Title

Signature		Date

Return this form to:		Dr. June F. Kearney
			Assistant Director of Athletics, Compliance
			Department of Intercollegiate Athletics
			California State University, Fullerton
			P.O. Box 6810
			Fullerton, CA  92834-6810
			Tel:  (714) 278-3431
			Fax:  (714) 278-5819