WITHDRAWAL FROM TEAM
Department of Athletics
(714) 278-3058 / Fax (714) 278-5396

	
	Student Name

	Social Security #

	Sport

1, 		 have voluntarily withdrawn from 	 for
	Student Name
 personal reasons.  According to NCAA regulations, I realize that my athletics grant-in-aid will be

 cancelled as of 		.
	Date

I am also aware that I have a right to a hearing if I do not agree with the conditions of this agreement.

		
Student-Athlete	Date

		
Head Coach	Date

		
Director of Athletics	Date

NOTE:  Institutional financial aid based in any degree on athletics ability may be reduced or canceled during the period of the award if the recipient voluntarily withdraws from a sport at any time for personal reasons.  (NCAA By-laws 15.3.4.1d)