SAF
ACADEMIC TESTING/SOFTWARE/CERTIFICATIONS
REQUEST FORM
All forms must be printed out and turned in with appropriate attachments.
Student-Athlete:
Sport(s):
G#:
Male/Female
Academic Year (circle one):
_Freshman _Sophomore _ Junior
_Senior
_5th Year Senior
Permanent Address:
Dormitory Building/Off- Campus Address:
Phone:
Email:
Have you or will you receive Pell Grant?
Yes:
No:
Please check the following as it pertains to
your athletic scholarship:
Full:
Partial:
Are you a International Student-Athlete?
Yes:
No:
None:
Please circle or fill-in the type of testing/software/certification that you are requesting for reimbursement.
____POST GRADUATE PLACEMENT TESTING:
GRE
____REQUIRED SOFTWARE/SUPPLIES:
CLASS____________________ SOFTWARE____________________________
____NATIONAL FITNESS CERTIFICATIONS:
NASM CSCS ACE
____OTHER
GMAT MCAT
LSAT
PRAXIS I
PRAXIS II
Please state the test/software/certification name on the line below
______________________________________________
Please explain your reasons for applying for academic reimbursement through the NCAA Student-Athlete Aid Fund.
Student-Athlete Signature:
Date:
Administrative use only
TOTAL MONIES REQUESTING FOR REIMBURSEMENT:
______________
Approved by:
Date:
Please print and return form to Ms. Resa Lovelace with ALL appropriate attachments.
Academic Testing/Software/Certification Reimbursements
POLICY STATEMENT:
Student-athletes have the opportunity to request reimbursement for the monies spent on the academic test/software/certification. The
test/software/certification must be geared toward the enhancement of a student-athlete’s placement into a post-graduate or professional
degree or certification program. A student-athlete is not limited to the types of test that they can take; however, they are not guaranteed
full reimbursement on every type of test they choose to take or the number of times that choose to take a particular test.
All applicants are eligible to receive up to $250 reimbursement for each Post-Graduate placement test (one reimbursement per
test)/software/certification during the academic year. By reducing the allotment, the fund can be granted to more student-athletes who
express the need for the fund. All requests that may be over the maximum allotment ($250) will be approved by a panel to
determine the need and availability of the money requested. For reimbursements to be processed and approved, the applicant must
provide clear and organized documentation of receipts and other validations of purchases. A failure to adhere to the following
requirements will ultimately result in a disqualification for reimbursement requests.
Sample tests placement/certifications include and are not limited to the following:
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GRE
GMAT
MCAT
LSAT
PRAXIS I, II
Required software for classes
National Certifications for Fitness and Recreation(i.e. NASM, CSCS, ACE)
Other Health Related Placement Testing (i.e. Nursing, Nutrition)
In order to receive full reimbursement for the test, a student athlete must furnish the following articles of documentation:

Receipt from Testing site or Course Syllabus

Receipt stating a “Proof of Purchase” (i.e. Bank Statement)

Verification that student completed test/course/certification
*This is not a complete list of both permitted and prohibited items.
For more specifications, please see Resa Lovelace, Coordinator of Student-Athlete Affairs (rlovela2@gmu.edu)
For more information
Acknowledgement of Policies and Procedures:
I hereby recognize the statements above as the primary means in which I can receive reimbursement up to the maximum amount of $250
for my placement testing/course software/certification. By signing this document, I understand that I am not GUARANTEED full
reimbursement for the tests that I take or the number of times I take a test. I also recognize that if I do not provide the documentation
necessary to prove my identity and placement of this test/course syllabus/certification test, I disqualify my chances of receiving
reimbursement for that particular test.
Signature of Agreement: _______________________________________________________________________
Printed Name: ___________________________________________________________________
Date: ____________________________________________________________________________
Sport: ___________________________________________________________________________
Test Taken: ______________________________________________________________________
Date of Test: _______________________________________________________ ____________