University of Nebraska Department of Athletics

UNIVERSITY OF NEBRASKA DEPARTMENT OF ATHLETICS

NEBRASKA AGENT QUESTIONNAIRE

Note: This Form Must Be Completed In Its Entirety (please print or type)

1.General Information

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Name:

Date:

Firm:

Evening Phone:

Fax:

E-mail:

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Daytime Phone:

Address:

2.Please list your educational background. Include dates attended and degrees conferred.

3.Please list your employment history for the last ten (10) years. Attach additional sheets if necessary.

4.Occupational or Professional Licenses

Are you currently certified by the NFLPA? Yes No Permanent Provisional

Are you currently certified by the NBPA? Yes No Permanent Provisional

Are you currently certified by the MLBPA? Yes No Permanent Provisional

Please list any other occupational or professional licenses or other similar credentials you have obtained other than college or graduate school degrees, including the dates they were obtained.

5.How many years experience do you have representing client-athletes?

6.Please identify which of the following services you provide for client-athletes:

Contract NegotiationFinancial Planning

Hourly fee or percentage Grievance Arbitration

Appearance/Endorsements Legal Assistance

Hourly fee or percentage Tax Planning

Estate Planning

Other services (please explain):

7.Do you offer a separate contract for each of the services identified above? (please explain)

8.Are your customary fees for the above services based on a percentage of the client’s salary that you negotiate, total income of the client, an hourly fee, or some other arrangement? (please explain)

9.For the services you perform for client-athletes, list the names and addresses of individuals, firms, or agencies which assist in providing these services. Use additional sheets if necessary.

10.Describe your fee structure. Are your fees negotiable?

11.Do you expect to be paid for your services “up front” or as the player is compensated?

12.Under what conditions may a client terminate a contract?

13.What happens if your client is waived from a team?

14.Do you limit the number of clients you will represent? If yes, please explain.

15.Do you have an agreement, understanding, or relationship of any kind with any individual, firm, or organization pursuant to which such an individual, firm, or organization solicits or encourages clients to use your services? If yes, please explain, including whether or not you provide any compensation or other consideration to such an individual, firm, or organization.

16.How many clients have you represented during your employment as a player agent?

17. How many clients are you currently representing in your capacity as a player agent?

18.Please provide the names and telephone numbers of five athletes that you previously or currently represent that may be contacted by the University of Nebraska Compliance Office or a University of Nebraska student-athlete.

19.Please list all University of Nebraska student-athletes that you currently represent or previously represented.

20.Please list which current University of Nebraska student-athlete(s) you plan to contact.

21.Have you ever been disbarred, suspended, reprimanded, censured, or otherwise disciplined or

disqualified as an attorney, as a member of any other profession, or as a holder or any public

office? If yes, please describe each action, the dates of the occurrence, and the names and

addresses of the authority imposing the action in question.

I certify that the above information is true, accurate, and complete to the best of my knowledge. Further, I certify that I will notify the Director of Athletics (or his designated representative) before the first contact with a student-athlete who had eligibility remaining in any sport and is enrolled at the University of Nebraska. I also have reviewed the NCAA rules and regulations that accompany this form and have not engaged in any activity that would jeopardize the eligibility of any University of Nebraska student-athlete. I understand that failure to comply with the terms of this certification and the applicable NCAA legislation may result in the initiation of legal proceedings by the University of Nebraska against me and the assessment of civil and/or criminal penalties to me.

Signature: Date:

Please return completed form and a photograph of yourself to:

Jamie M. Vaughn

Associate Athletic Director of Compliance

Student Life Complex

One Memorial Stadium

Lincoln, NE 68588-0219

Office: 402-472-2042

Fax:402-472-6961

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