Stanford University Department of Athletics Athlete Agent & Advisor Registration Form

Stanford University Department of Athletics Athlete Agent & Advisor Registration Form

General

Any agent, as defined by the California Miller-Ayala Athlete Agents Act and the NCAA, must be registered with the Stanford University Compliance Services office prior to having communication with Stanford student-athletes. If you have not previously registered with the Stanford Compliance Services office, please complete the Stanford Athlete Agent Registration form below. Please contact the Compliance Services Office (stanfordcompliance@stanford.edu) with any questions.

First Name*

Last Name*

Firm/Agency Name*

Firm/Agency Website*

Business Mailing Address: Street, City, State, Zip*

Work Phone*

Email*

Athlete-Agent Registration Type

I am registering as a professional service provider who provides:

Name, Image, and Likeness (“NIL”) representation only

Professional athletic representation only

Both NIL and professional athletic representation

Stanford Athlete Agents & NIL Policy Confirmation*

I confirm I have reviewed Stanford University Policy for Athlete Agents and Stanford's NIL Resource Website

Stanford Athlete Agents Policy Confirmation*

I confirm I have reviewed Stanford University Policy for Athlete Agents found at I confirm I have reviewed Stanford University Policy for Athlete Agents

NCAA Rules Confirmation*

By checking this box, I understand that NCAA rules still prohibit professional service providers (i.e., agents) from marketing the athletics abilities of student-athletes to professional sports teams or organizations. Per NCAA rules, should a professional service provider market the athletic ability of a student-athlete to pursue professional sports opportunities, the student-athlete is deemed no longer eligible for intercollegiate athletics. In representing a student-athlete with remaining eligibility, and who plans to retain their intercollegiate eligibility, the professional service provider is limited to NIL representation only.

Interest in Current Student-Athletes

What sport(s) does your agency work with?

Please list the name and sport of any current Stanford student-athlete(s) you are interested in contacting:

State of California

State of California Registration*

All agents applying to communicate with Stanford student- athletes must be registered with the State of California. A copy of such registration, or a notice of pending registration, must be included with this.

I am registered with the State of California

My registration application is pending approval

Other State Athlete Agent Registrations

Please provide all current and pending registration information for other state(s) you're registered in. Attach additional documentation at the bottom of this form, if necessary.

State/Status/Expiration Date

Legal

Non-lawyers, proceed to next section.

Lawyers Only

Please list all jurisdictions in which you have been admitted to practice law and any pending applications. Specify the jurisdiction, status and date for each. Attach additional documents at the bottom of this form, if necessary.

Players' Association Information

Registrations/Certifications

Check all that apply and enter all requested dates. Attach a copy of your current, valid registration for each organization selected at the bottom of this form.

Major League Baseball Players’ Association (MLBPA)

Expiration Date

National Basketball Players’ Association (NBPA)

Expiration Date

NCAA Certification

Expiration Date

National Women’s Basketball Players’ Association (NWBPA)

Expiration Date

National Football League Players’ Association (NFLPA)

Expiration Date

NFLPA Registered Financial Advisors Program

Expiration Date

Other

Other Registration Name

Expiration Date

Business Associates

Please list any business associates (e.g., runners, marketing associates, etc.) that work with you or your firm / agency, if applicable:

Names and Roll with Firm/Agency

Additional Background

Background Information

Check any of the following situations that apply to you and attach complete information regarding each occurrence, charge, incident, or declaration, including dates, result/status, and authority overseeing the action. Have you ever:

Been investigated, suspended, or disciplined by the NCAA or any conference, university, college, players association, sports league, state regulatory body, professional sports counseling panel, bar association, or other federal, state, or local entity responsible for agent, attorney, or other professional licensure?

Yes

Been convicted or plead guilty to a criminal charge other than minor traffic violations?

Yes

Been a defendant in a civil proceeding, including bankruptcy, involving allegations of fraud, misrepresentation, embezzlement, misappropriation of funds, conversion, breach of fiduciary duty, forgery, or legal malpractice?

Yes

If you answered yes to any of the questions listed above, please explain:

Stanford University Department of Athletics Agent Registration Form - Athlete Agent Attestation*

Stanford University Department of Athletics Agent Registration Form ("Registration Form") will not be processed until all of the required information has been provided.

By submitting this Registration Form and typing my name below:

I confirm I have attached all of the documentation requested within this application.
I certify that the information provided in this Stanford University Agent Registration Form is true, accurate, and complete to the best of my knowledge.
I agree to be bound by and conform to California State law, NCAA rules, any other applicable laws, and any Stanford team policies that may apply to my interaction(s) with a Stanford student-athlete(s).
I understand that failure to comply with any of the aforementioned authorities may result in the initiation of legal proceedings by Stanford University against me and the assessment of civil and/or criminal penalties.
I certify that I have not engaged in, nor will engage in, any activity that could jeopardize a student-athlete’s collegiate athletics eligibility.
Further, I certify that I will notify the Stanford Compliance Services Office before making contact with a Stanford student-athlete who has eligibility remaining in any sport and is enrolled in Stanford University or before contact with the student-athlete’s family and friends.
I will notify the Stanford Compliance Services Office should any of the information contained in this application change at any point in the future.
I understand that the information contained herein is public in nature and may be provided by Stanford University to its student-athletes, coaches, staff, faculty, families, and others.

Document Checklist

You must attach the following information to complete the registration process:

A copy of your State of California Athlete Agent registration, or a notice of pending registration. (See example of registration here)
A copy of your current, valid registration for all Players’ Associations selected, if applicable.
A copy of your standard representation contract.

Please use the below File Attachments to upload all files. Note you can upload multiple files.

File Attachments*

Drag and drop files here or

Resources

Stanford University Policy for Athlete-Agents

Stanford University NIL Resource

Send me a copy of my responses

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