Declaration of Pre-Existing Relationship Form

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CANISIUS College Athletics Declaration of Pre-Existing Relationship

This form is to be completed anytime an institutional employee or athletics booster believes he/she has a pre-existing relationship with a prospective student-athlete, a current Canisius student-athlete, or a parent, friend or relative of either.

Certain actions by institutional employees and/or athletic boosters may be in violation of NCAA bylaws if they are considered to be giving preferential treatment, benefits, or services to an individual because of his/her athletics reputation or potential payback as an athlete. However, if a pre-existing relationship is found to have been established between the employee/booster with the prospect and/or student-athlete, these actions may be permissible provided they have not changed due to the individual’s status as a prospect or student-athlete.

Please answer the following in order to determine if a pre-existing relationship has been established and the nature of such a relationship.

Institutional Employee or Booster Phone Number Email Address Address City, State Zip Code Prospect, Student-Athlete, or Relatives/Friends Of (Please list all names that apply) When did your relationship with the above individual(s) first develop?

/ When did the athlete in question become a prospect (enter 9 th grade)? When did the athlete become a collegiate student-athlete (if applicable)? Month Month Month / / Did this relationship develop as a result of the individual’s participation in athletics? Yes Please describe when you first met the above individual(s) and how your subsequent relationship developed. Year Year Year No Has your relationship with this individual changed since he/she has become a prospective or current student-athlete? If yes, please describe the nature of the change. Has your relationship with the above individual(s) been continuous?

If no, please list the nature of any interruptions of this relationship.

Yes Yes No No

CANISIUS College Athletics Declaration of Pre-Existing Relationship

Please complete the following detailing the nature and frequency of benefits provided to the above individual(s) during the course of your relationship.

Meals provided Never Rarely Occasionally Frequently Home visits/stays Never Rarely Occasionally Frequently “Away from home” Entertainment

Ex. dining out, movies, sporting events, etc.

Never Rarely Occasionally Frequently “Away from home” Entertainment

Ex. Holidays, Birthdays, special events, congratulations, etc.

Travel

Ex. Family vacations, out of town trips, etc.

Never Never Rarely Rarely Occasionally Occasionally Frequently Frequently Please list specific examples of typical benefits provided to the individual(s), the nature/frequency of such benefits, and the value of such benefits.

By signing this document, I certify that to the best of my knowledge, the above answers are complete and accurate. Furthermore, I understand that if the nature of my relationship is not considered to be “pre-existing” in accordance with NCAA regulations, certain benefits provided to or the preferential treatment of the above named individual(s) could result in a NCAA violation and potentially affect the eligibility of the prospective student-athlete and/or Canisius student athlete.

Date Signature of Institutional Employee or Booster

COMPLIANCE APPROVAL This relationship is considered “pre-existing.” This relationship does not meet the criteria to be considered “pre-existing.”

Signature of Compliance Director Date

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