NCAA - Special Olympics Tracking

This form should be completed and submitted by every conference or campus that contributes to the Special Olympics – Division III partnership. The intent of this form is to document the efforts of Division III student-athletes to the Special Olympics - Division III partnership.

* - Required Field

*Your Name: *Title (e.g., SAAC Liaison; Director of Athletics): *Email Address: *Phone Number: *Institution *Conference: *Championship: *Number of Division III student-athletes participating: *Number of Special Olympics Athletes participating: *Number of other participants: *Number of hours served: *Total number of hours dedicated:
( # of participating student-athletes x number of hours = total amount of time dedicated) *Dollar amount raised: *Name of Special Olympics group worked with: *Brief description of the fundraiser/project/event involving Division III student-athletes and Special Olympics. Describe the event including, but not limited to, purpose, place and participation. Projects may include fundraising, Special Olympic events or other efforts that occur following commencement of the 2012-13 academic year. *If this was a fundraising or donation effort, please indicate the amount of funds raised or provide a description of the donation. Please also detail the Special Olympics group that you donated to (e.g., national, local, state branch). Did your institution write a story about your Special Olympics event? If so, please provide the link here:

National Collegiate Athletic Association