Agent Registration Form

Agent Registration Form

University of Tennessee Department of Athletics
Please read the University of Tennessee's agent policy and applicable Tennessee state law prior to filling out this form.

Complete the following form to register with the University of Tennessee Athletics Compliance Office.
- Agency Name
- Names of Agent/Representative
- Agency Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Phone
  
  Area CodePhone Number
- Fax
  
  Area CodePhone Number
- Cell Phone
  
  Area CodePhone Number
- E-mail
- Please list all institutions attended, along with dates attended and degrees earned.
- Institution 1
  Institution Name
- Institution 1
  Dates Attended
- Institution 1
  Degrees Conferred
- Institution 2
  Institution Name
- Institution 2
  Dates Attended
- Institution 2
  Degrees Conferred
- Institution 3
  Institution Name
- Institution 3
  Dates Attended
- Institution 3
  Degrees Conferred
- List the sports for which your agency provides representation:
- Other sports represented:
  Please List
- Are you certified by the NFLPA?
- Date of NFLPA Certification
  
  MonthDayYear
- Are you presently certified by the NBPA?
- Are you presently certified by the MLBPA?
- List any other occupational or professional licenses and the dates on which they were obtained
- i. How many years of experience do you have representing client-athletes?
- ii. Please identify the following services you provide for client athletes:
- Hourly fee or percentage for appearance / endorsements?
- Other services provided for client-athletes:
- iii. Do you offer a separate contract for each of the services identified in this section? (please elaborate)
- iv. For the services you perform for client-athletes, list the names and addresses of individuals, firms, or agencies which assist in providing these services. You may also upload a file (.pdf .doc or .txt) below.
- Upload File
  
  Upload a File
  
  Cancelof
- v. Describe your fee structure. Are your fees negotiable?
- vi. Under what conditions may a client terminate a contract?
- vii. Do you limit the number of clients you represent? If yes, please elaborate.
- ix. How many clients do you currently represent?
- x. Please list the names and phone numbers of three athletes you currently represent or have represented who may be contacted by the Tennessee Compliance Office or a Tennessee student-athlete:
- xi. Please list all former University of Tennessee student-athletes that you currently represent or have represented:
- xii. Please list the current University of Tennessee student-athletes you plan to contact:
- I certify that the above information is true, accurate, and complete to the best of my knowledge. Furthermore, I certify that I will notify the Compliance Office before the first contact with a student-athlete who has eligibility remaining in any sport and is enrolled at the University of I have reviewed the Agent Policy, applicable law, and NCAA rules and regulations and have not engaged in any activity that would jeopardize the eligibility of any University of student-athlete.
  
  I understand that failure to comply with the terms of this certification, law and the applicable NCAA legislation may result in the initiation of legal proceedings by the University of against me and the assessment of civil and/or criminal penalties to me.
- I have read and agree to the above.
- Should be Empty: