OFFICIAL NAIA HARDSHIP REQUEST CERTIFICATE



NAIA Exemption Worksheet

This worksheet may be used to prepare for submitting the Year-End Report information online in NAIAHelp.

|Institution: |      | |Academic Year: |      |

| |A |B |C |D-1 |D-2 |E |F |

|Total Aid Granted prior to any

Exemptions |Number

of Students Exempt |Countable Aid Exempted |Number

of Students Exempt |Countable Aid Exempted |Number

of Students Exempt |Countable Aid Exempted |Number

of Students Exempt |Countable Aid Exempted |Total Number

of Exemptions |Total Countable Aid Exempted |Subtract Column E

from Column A | |Cross Country-M |$       |       |      |      |      |      |      |      |      |      |      |      | |Cross Country-W |$       |       |      |      |      |      |      |      |      |      |      |      | |Football |$       |       |      |      |      |      |      |      |      |      |      |      | |Soccer-M |$       |       |      |      |      |      |      |      |      |      |      |      | |Soccer-W |$       |       |      |      |      |      |      |      |      |      |      |      | |Volleyball |$       |       |      |      |      |      |      |      |      |      |      |      | |Basketball-M I or II |$       |       |      |      |      |      |      |      |      |      |      |      | |Basketball-W I or II |$       |       |      |      |      |      |      |      |      |      |      |      | |Swimming/Diving-M |$       |       |      |      |      |      |      |      |      |      |      |      | |Swimming/Diving-W |$       |       |      |      |      |      |      |      |      |      |      |      | |Track & Field-IN-M |$       |       |      |      |      |      |      |      |      |      |      |      | |Track & Field-IN-W |$       |       |      |      |      |      |      |      |      |      |      |      | |Track & Field-OUT- M |$       |       |      |      |      |      |      |      |      |      |      |      | |Track & Field-OUT-W |$       |       |      |      |      |      |      |      |      |      |      |      | |Wrestling |$       |       |      |      |      |      |      |      |      |      |      |      | |Baseball |$       |       |      |      |      |      |      |      |      |      |      |      | |Softball |$       |       |      |      |      |      |      |      |      |      |      |      | |Tennis - M |$       |       |      |      |      |      |      |      |      |      |      |      | |Tennis - W |$       |       |      |      |      |      |      |      |      |      |      |      | |Golf - M |$       |       |      |      |      |      |      |      |      |      |      |      | |Golf - W |$       |       |      |      |      |      |      |      |      |      |      |      | |

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