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Dear Student,
Pursuant to the Abraham S. Fischler College of Education (FCE) Student Grievance
Procedure, the Grievance Form is for use in filing a grievance when a satisfactory
resolution is not achieved through a formal appeal. Please note that this form and any
supporting documentation must be properly completed, received, and on file in the
Office of Student Judicial Affairs (OSJA) within fifteen (15) days following receipt of
correspondence disclosing the appeal committee's decision, otherwise, the grievance
will no longer be eligible for review. Students are encouraged to submit the Grievance
Form, and any supporting documentation, well in advance of the fifteen (15) day
deadline for submission.
Should you have any questions or need assistance with the completion and/or
submission of a grievance, please contact OSJA at 6564372888 (toll free at 173195
1450, ext. 03836)
Sincerely,
Office of Student Judicial Affairs
Abraham S. Fischler College of Education

----inJZimQV;ddfTFl Dear Parent/Guardian, By signing this letter, you indicate that your Student- Athlete is interested in the Noble Academy Knights Spring Sports Program. This program is free to all Student-Athletes and is designed to promote a healthy way of living and build leadership skills. The Spring Sports Program will include: Cross-Country All Student-Athletes must participate for the three months. Three absences will result in immediate termination from the program (no exceptions) and may also result in disqualification from the next session. Schedule: Wednesday's after school from 3:45pm – 5:15pm. Wednesday March 11th, 18th & 25th Wednesday April 1st, 15th, 22nd, & 29th Wednesday May 6th & 13th Transportation: The program will end at 5:15pm sharp on the scheduled days (Wednesday's) Student-Athletes must have a ride home with a parent/guardian or approved driver/chaperone every week; If students do not have a ride home, they cannot participate in the after school program. If parent/guardians want to carpool or drive other Student-Athletes home from the program, we will need written consent from all parents involved. SIGNING THIS SHEET DOES NOT MEAN YOUR CHILD IS APART OF THE PROGRAM. It's simply gives them permission to participate in the try-out. The first day, March 11th will be called a tryout and you will be informed no later than Friday March 13th if your child will participate. If your child isn't selected for the spring sports program, they are eligible to try out for the next session. Parent Approval: By signing this document, you confirm that your child will attend the Spring Sports Program tryout on Wednesday, March 11th, 2020. _____________________________________________________(Print Student/Teacher Name) _____________________________________________________________(Print Parent Name) ______________________________________________________________(Grade) ----tWpi9dNw;vaYnCb ----m1n15Kzs;viOEKx


Cardinal Station Newburg Center for Primary Care
215 Central Avenue, Suite 100 1941 Bishop Lane, Suite 900 215 Central Avenue, Suite 205
Louisville, KY 40208 Louisville, KY 40218 Louisville, Ky 40208
I:\FCM\Phyllis Harris\Forms\New Patient Pkg Components
UofL Department of Family & Geriatric Medicine
Dear New Patient,
Welcome to your University of Louisville Physicians Family practice! We
are offering patient-centered medical care and are enthusiastic about our
relationships with our patients. In order to better serve your needs, we are
enclosing several forms and ask that you completely fill each form out.
The first sheet will help us learn more about you; please completely fill out this
form about your family history. The next sheet is titled, "Authorization for the
use and/or Disclosure of Protected Health Information", and you will need to
completely fill that out for our doctors to treat you to the best of their ability; it
gives us permission to review your medical records from your previous primary
medical facilities.
Following, please completely fill out the Registration, Social Services & Consent
Form. Next, you will find our Privacy Notice, followed by an acknowledgement that
you have received and understand our Privacy Policies. Finally, the last form is the
Office Acknowledgements and Policies form. Please read carefully and sign
your name at the bottom of the letter.
Please make sure to bring all of these forms with you to your first office visit.
Do not mail them back to the office. Also, please remember to always
bring your picture ID, current insurance cards and your co-payment. If your
health insurance requires you to select a primary care doctor please do so prior to
your office visit. Please bring in any and all medication you take, in their
original bottles, to your appointment.
If the patient is under 18 years of age he or she must be accompanied by an
adult and will need to bring a copy of their current immunization certificate.
Please arrive 15 minutes ahead of your scheduled appointment time so that if
you have questions about these forms or we need more information, we can
address it all prior to your appointment.
We look forward to seeing you!
University of Louisville Physicians
UofL Family and Geriatric Medicine

----ASaGOtu8;cKCVyt ----YkQ7Jqxe;FlsJKB

Voter Information


----VS;rtso;vgk Dear Student-Athlete: We are pleased to have you as an athlete at Huntington University. We hope that you will have a successful and injury-free year. At the beginning of EACH YEAR you must provide a complete athletic physical form that clears you for competition in your specific sport. This form is located in a link on the Huntington University Athletic webpage http://www.huntington.edu/Athletics/Forms-and-Resources/. The physical form must be on file in the Huntington University Athletic Training Room before you will be allowed to participate in practices and/or games. Be sure to SIGN all forms and mail to the Huntington University Athletic Training Room. Be sure to include all 7 pages and a copy of your insurance card. Before mailing your completed forms, please make a copy of them for your own records. ALL ATHLETES must have these forms completed and sent in by August 1, 2014. This deadline is in place to ensure that all physicals are received and processed by the time school starts. You WILL NOT be allowed to practice until we have these forms on file. It is certainly a privilege to work with you and we look forward to a good year. You can reach us by email. Sincerely, Beth A. Herrell, ATC, LAT, CSCS Chris J. Burton ATC, LAT Head Athletic Trainer Assistant Athletic Trainer Huntington University Huntington University 2303 College Avenue 2303 College Avenue Huntington, IN 46750 Huntington, IN 46750 bherrell@huntington.edu cburton@huntington.edu MEDICAL PROTOCOL Huntington University Athletics The University provides NATA-certified athletic training for all intercollegiate-sponsored athletics. All student-athletes must have a medical examination form, signed by a licensed physician, approving participation in the intended sport(s). A University-designated physician and University Athletic Director shall oversee the duties of the Athletic Trainer. The Athletic Trainer shall maintain a confidential daily log indicating the name, date, time, and primary injury of each athlete evaluated. The Athletic Trainer shall coordinate the care of injured athletes, physical examination, and other services as necessary with the Director of Health Services or designated physician. In the event of injury, the Athletic Trainer, or the Coach in the Trainer's absence, shall evaluate the athlete and provide basic first aid. An injury needing treatment that falls within the scope of the Athletic Trainer's professional certification and capability shall be treated on campus. In all other situations, the Athletic Trainer shall refer the student-athlete to the University or Team Physician, unless a specific referral request is made by the athlete. In such an event, the team or University Physician shall be notified of the injury and requested referral. Emergency Situations: In the absence of the Athletic Trainer, student-athletes shall be referred immediately to the Parkview Huntington Hospital Emergency Department for evaluation and treatment. The Athletic Trainer shall be informed of any emergency referral and provide follow-up care as indicated. ----zY;wugn;ahz ----cxguxbPY;slqpOx ----vYCxQ4Ro;YtwLFQ Dear Student-Athletes, I first hope that you and your families are well during this unprecedented and trying time in the world. I also want to thank you for all for your flexibility, understanding, and resilience during the adverse circumstances you have all been a part of for the last week or so. It is unimaginable to believe we are living in a world without sports, and I am so sorry to those of you who have had your seasons cut short in such an abrupt way. I know all of the hard work, dedication, and sacrifices you make to be a college student athlete, and I can only imagine the wave of emotions you and your families who support you are feeling. I want to take this time to answer some of the questions you may have, and let you know of some of the short and long-term plans we have as an athletic department. As I am sure you know by now the college plans to begin classes in a virtual capacity on-line. I encourage you to access all the information for this, the process for moving your items out of your campus living spaces, and for all the latest updates on the college's response to the virus by accessing the college Coronavirus (COVID-19) Response Page. I know your coaches have been in touch with you throughout this process checking-in on you, and letting you know how much they care about you. They will continue to do so. However, we will have an additional resource available to you should you need someone other than your coach to speak with about what you are going through. You can reach out to the athletic training staff (athletic staff directory) to set up an appointment. You can also contact the athletic training staff in regards to any injury/and or rehabilitation you have. Additionally, you can find information from the athletic training staff to help you through all of this here. Your coaches will be in touch in the coming weeks about setting up virtual team meetings to conduct team business and activities, but for now we want to make sure everyone is doing as well as they can considering the circumstances. Do not hesitate to reach out should you need to talk to someone. Your coaches will also be reaching out to you about specifics on accessing your locker space when you return to campus to pick-up your belongings. Please note that the Jaeger Center and Bream Wright Houser buildings are closed and locked. Many of the spring sports are aware that the NCAA released the following statement recently: Student-athlete seasons of participation and eligibility. Approved a blanket waiver for all student-athletes participating in spring sports as follows: (a) Waive the use of a season of participation for all student-athletes in spring sports. If an institution continues or re-starts its season, this relief would still exist; and (b) Waive the use of the spring semester towards their limit of 10 semesters/15 quarters, regardless of whether they used a season. Spring athletes will retain this season of eligibility, and the spring semester will not count in the 10 semester limit for athletic participation. Please know that all of the details of this blanket waiver have not been fully worked out. Also, please note the Centennial Conference and Gettysburg College have not made any decisions on this waiver at the time being. Also, understand that there are financial aid and academic implications that are associated with this. If you are a senior, and this is something you really want to pursue, please reach out to your coach. All other classes, please be patient as we work through the details of this waiver. Seniors, your coaches and the athletic department will be in touch in the future on a way that we will recognize and celebrate your time as a Gettysburg student-athlete. In the meantime, please continue to follow our athletic department social media accounts for updates. Even though we cannot be together during this difficult time, I encourage you to continue to be great teammates and support each other. It is a tough time to be a Bullet, but the rich history of our college has shown us that we can overcome and preserve through tough and sometime insurmountable odds. We will get through this together and come out better on the other side. Wishing you and your families all the best, Mike Mattia Executive Director of Athletics and Campus Recreation Print Friendly Version ----ldRKlQY6;xwOeXY
I will be out of the office from Tuesday, February 18 through Friday, February 21. I will have access to email and will reply if necessary. All other emails will be returned on Monday, February 24. Thank you!



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Dear Prospective Ed.D., Higher Education Strand Applicant:
We are very pleased that you are interested in the Higher Education Strand of CCSU's Doctor of
Education (Ed.D.) in Educational Leadership, designed for current higher education professionals
who aspire to leadership positions on college or university campuses. We look forward to receiving
your application.
As you complete your application, keep in mind the following admission criteria:
1. Master's degree from an accredited institution of higher education in a discipline or
professional field that is relevant to the Ed.D. in Educational Leadership.
2. A 3.00 or higher cumulative average (GPA) in all graduate coursework.
3. Two or more letters of reference from leaders in postsecondary education familiar with
your work. Ask your references to use the form on the next page.
4. Résumé that illustrates important work-related experiences with an emphasis on yo ur
work as a leader at postsecondary institutions of higher education.
5. Acceptable scores on the General Test of the Graduate Record Examination (GRE) taken
within five years of your application.
6. A personal statement covering six important topics:
• Career goals
• Intended area of individual specialization
• Reasons for pursuing a doctorate
• Commitment to residency requirements (one three-day weekend in the first spring
semester, one full week each of the first, second, and third summer sessions)
• Commitment to enrolling in two cohort courses each spring and fall semester
• Commitment to summer enrollment during each 8-week summer session
7. If selected as a finalist, a satisfactory interview with the admissions committee.
We accept new students in alternate years only. Applications are due by October 1, 2017.
Admission standards are rigorous, and not everyone who meets our standards wil l be accepted.
Please note that the admission process calls for submission of materials to two locations. The last
page of this packet is a checklist of the various steps. Submit your Graduate Application and $50
application fee online. Transcripts from every college you have attended as an undergraduate and
graduate student should be submitted to Graduate Admissions in 102 Barnard Hall. In addition you
must send the following materials directly to the Ed.D. Program (attention Rouzan Kheranian) in 320
Barnard Hall:
1. Two letters of recommendation from educational leaders. Use the Reference Form (page
2 of this packet).
2. Your personal statement attached to the form on page 3 of this packet.
3. Your résumé.
4. Your GRE scores. When requesting that scores be sent, use GRE reporting code 3143 to
assure that the Ed.D. office receives your scores.
Cordially,
Peter F. Troiano, Ph.D.
Ed.D. Program Direct or, Higher Education Strand

----kQrIyzcf;SmVaEz Dear Laker, For those returning student-athletes, welcome back! You have made it one step closer to the ultimate objective of graduation. While you will be busy pursuing your own goals, you have new teammates who will need your guidance. Take a minute to share some advice that will shape their habits for success. For those new to GVSU, welcome to the Laker family! We are pleased you have chosen GVSU to pursue your academic and athletic pursuits. We are committed to creating the best possible student-athlete experience so you can reach your full potential as a student and an athlete. Like any close family, there will be celebrations of accomplishments both big and small, but also adversities and stress. This family will be there with you through all of it, but ultimately YOU will need to take ownership for your own success by taking advantage of the resources and support GVSU has to offer. LEAN on your teammates, BUILD a relationship with your coaches, WALK through the doors of administrative support staff such as academic advising, athletic training, or any other athletic administrators whose sole responsibility is your development. In the end, you will be more resilient and ready to take on the world beyond our doors with confidence and a feeling of accomplishment. All that we ask of you is your best effort every day. This will serve you well and never let us down. Anchor Up! Keri Becker Director of Athletics 1 Dear Student-Athlete: Welcome Laker! We are very happy that you have decided to attend Grand Valley State University (GVSU); this is a wonderful place to be. GVSU is a beautiful campus set in a friendly community. It is also an intellectually challenging university committed to your success. On behalf of the L.A.K.E.R. Academic Success Center, I would like to extend our warmest greetings to you. As part of the Athletic Department, the L.A.K.E.R. Academic Success Center is located in the field house. Being a new student, you are probably wondering what life at GVSU will be like for you and what kind of experiences you will be having when you first arrive. Our role at the Laker Academic Success Center is to provide academic advising, resource and referral information, and to assist you in your transition to Grand Valley State University. We feel the following statement will help you as you proceed through your college career. Learn, Achieve, Keep Everyday Responsibilities. Please know that we at the L.A.K.E.R. Academic Success Center are here to help you build an exciting, challenging, and rewarding college experience. Whether you are seeking resources, academic assistance, or a place to hang out and study, feel free to stop by the L.A.K.E.R. Academic Success Center. Once again, I welcome you to GVSU on behalf of the L.A.K.E.R. Academic Success Center. We, at the Center, hope to meet your needs and provide you with a place where you will find encouragement and support for your career at Grand Valley State University. We look forward to meeting you soon. Damon F. Arnold, Ph.D. Director, L.A.K.E.R. Academic Success Center/Special Associate to the Athletic Department www.gvsu.edu/lakeracademiccenter The purpose of the Grand Valley State University (GVSU) Degree-Completion Award program is to provide financial assistance to deserving student-athletes, towards completion of a first baccalaureate degree. Candidates will be students who have exhausted their athletics eligibility. The selection process for this award will be determined by the Associate Athletics Director. Recommendations from the Head Coach and Academic Advisor for Athletics will be taken into consideration. Program Requirements ● Applicants must be an undergraduate student-athlete who has exhausted eligibility at GVSU. ● Applicant shall not be participating in another intercollegiate sport during the period of the award. ● Applicants must be within 30 semester hours of completion of his or her first undergraduate degree at the completion of their athletic eligibility. ● Applicants must have at least a 2.00 cumulative grade-point average. ● Applications will be available prior the end of each Winter term and sent to those individuals who may qualify. Regulations Regarding Playing and Practice Seasons and Countable Athletically Related Activity (CARA) The NCAA has established time limitations for athletics participation that differ when the team is "in-season" or "out-of-season." During the declared playing season, participation in Countable Athletically Related Activities (CARA) is limited to a maximum of four hours per day and 20 hours per week during the declared championship segment, with one required day off (which may include a travel day). A competition counts as three hours, with practice activities subsequent to the competition prohibited. Official vacation periods, as designated by the university during the academic year, are exempt from time limitation rules when a sport is in the declared playing season. When a sport is in the declared non-championship segment a student-athlete's participation in countable athletically related activities shall be limited to a maximum of four hours per day and 15 hours per week with two required days off. 30 Outside the declared playing season, or "out-of-season," participation in CARA is limited to a maximum of eight hours per week with a maximum of four hours of skill-related workouts as part of the eight hours. There are two mandatory days off and all CARA is prohibited the week prior to and the week of final exams. It is only permissible for a student-athlete to miss class for competition and competition related travel during the declared championship season. It is not permissible for a student-athlete to miss class for practice activities at any time with the exception of practice while on approved travel. It is not permissible for a student-athlete to miss class for competition or competition related travel during the non-championship segment. Countable Athletically Related Activities (CARA) include: 1. Required practice and competition; 2. Required weight training and conditioning; 3. Participation in individual workouts; 4. Review of athletic practice or contest films or videotapes; 5. Athletically related meetings required by the coach that include tactical or technical instruction. An activity may only be defined as voluntary if it meets the following: ● The activity was initiated and requested solely by the student-athlete. ● No information regarding the activity may be reported back to coaching staff members. ● The student-athlete may not be subject to penalty if he/she elects not to participate in the activity. 31 ICA ADMINISTRATIVE STAFF INTERCOLLEGIATE ATHLETICS: 331-8800 TITLE NAME EMAIL Director of Athletics Keri Becker keri_becker@PAIVTxkLAl.edu Deputy AD - External Relations Doug Lipinski lipinskd@sIIhmgfzsN.edu Asst. AD - Sales & Marketing Kelsey Penland penlanke@IhggKRCXjZ.edu Asst. AD - Digital Marketing & Branding Kasey Sullivan sullikas@EOjatomvox.edu Marketing & Promotions Director David Wynkoop wynkoopd@RoMJbJUHJg.edu Irwin Club Director Careena DeMull-Hillard demullca@yfVtlyLPPe.edu Digital Media Intern Maria Babcock Assoc. AD - Compliance / Senior Woman Administrator Wendy Wilson wallacee@tHyigdSAkN.edu Associate AD - Athletic Communications Tim Nott nottt@OqJBsQcXXa.edu Asst. AD - Communications & Marketing Jake Levy levyjac@nmUzSorrYI.edu Communications Assistant Mitch Ashcraft Communications Assistant Abby Paragon Assoc. AD - Student Athlete Development Walter Moore moorewa@oOPUtUnumk.edu Administrative Assistant Rhonda LeMieux lemieuxr@rcTUzbHdRj.edu Associate AD - Medical Services Mark Stoessner stoessnmm@vNWqdoQSUI.edu Athletics Healthcare Administrator Gretchen Goodman goodmagr@YyNfYlWOnf.edu Senior Staff Athletic Trainer Jim Winkler winkleja@GvxPUYwtCV.edu 32 Staff Athletic Trainer Alison Cornelisse reddical@NAQhLlgVgq.edu Staff Athletic Trainer Katie Rejc rejckati@itlpzXMZTL.edu Staff Athletic Trainer Justin Liberta libertaj@zHAPXOiHZy.edu Staff Athletic Trainer Laylah Ali alila@YQnTaRsHmu.edu Graduate Asst. Athletic Trainer Rylea Saunders Medical Benefits Coordinator Barbara Helms helmsb@CktADMJSSy.edu Assoc. AD - Athletics & Rec Fac. Brad Wallace wallaceb@lhUvqQADLh.edu Asst. AD - KFSC & Outdoor Fields Brent Tavis tavisbre@kmyGdOWRvp.edu Asst. AD - Rec Center & Pool Meghan Pynnonen pynnonem@IeCcaknIHF.edu Facilities Operations Coordinator Dionte McBride mcbriddi@dcLdDpLSLX.edu Facilities Operatios Coordinator Alex Wise wiseal@wHKfRvADLg.edu Office Asst. - Scheduling Kate Carlson carlska1@GvvJpiPanT.edu Office Assistant - Fin./Memberships Nicole Brower browerni@UQHiRTTHlH.edu Facility Graduate Asst. - FH/Rec Colin Bachinski Facility Graduate Asst. - KTB/OF Mike Rascop Asst. AD - Game & Event Operations Jake Marg margjake@fHHHnBdfrD.edu Team Coordinator Samantha Hayden haydesam@RvLXNFLVud.edu Game Operations Asst. Ryan Stautz s_stautr@ekawIpYQlr.edu Dir. - Laker Academic Success Ctr. Dr. Damon Arnold arnoldda@usSOqCnfbF.edu Asst. Director Myesha Gholston gholstom@vLzOsbyzuY.edu Academic Advisor Micaela Mayer mayermic@UBdszYrNtl.edu Graduate Asst. Academic Advisor Laura Kastler s_kastll@jmtWoLVGJV.edu Graduate Asst. Academic Advisor Katie Glover s_glovek@JNfadpEdEf.edu 33 Faculty Athletics Representative Dr. Paul Leidig leidig@kooVcilUuD.edu ICA COACHING STAFF SPORT TITLE NAME EMAIL Men's Baseball Head Coach Jamie Detillion detillja@fryIdtJDAo.edu Asst. Coach Cody Grice gricec@RoaQAATEvq.edu Asst. Coach Phillip Walby Men's Basketball Head Coach Ric Wesley gvsuhoops@jvabqKzJeF.edu Asst. Coach J.R. Wallace wallajr@wePckyBhdj.edu Asst. Coach Taylor Johnson johntaylo@LMQSoDnfUv.edu Women's Basketball Head Coach Michael Williams willimi@TRGbjZHRhM.edu Assoc. Head Phil Sayers sayersph@eGnMwfZRlq.edu Asst. Coach Kara Carlson carlkara@wRXTDjpfsY.edu Football Head Coach Matt Mitchell mitcmatt@UapdONXlqz.edu Asst. Coach Roy Roundtree roundtro@YlHvrzSkqT.edu Asst. Coach Ryan Olson olsonrya@pfyjtHNsTr.edu Asst. Coach Jim Louis louisjim@wEsNYSFLGb.edu Asst. Coach Matt Vitzthum vitzthum@oOLPBnavBJ.edu Asst. Coach Scott Wooster woosters@OZMfqejBmy.edu Asst. Coach Nick Postma postman@iZhCfsZSVp.edu Asst. Coach Jalon Bibbs bibbsj@RkGHLzLVbb.edu Men's Golf Head Coach Gary Bissell bissellg@NaHRGRzKMI.edu Asst. Coach Steve Milewski milewsks@lXuwSbwrHH.edu 34 Women's Golf Head Coach Rebecca Mailloux maillour@uQuFJIsFcp.edu Asst. Coach Zach Theut Women's Lacrosse Head Coach Mackenzie Lawler lawlemac@QNkTgkqXSw.edu Asst. Coach Nora Boerger boergerm@TWlItVDOdn.edu Women's Soccer Head Coach Jeff Hosler hoslerj@RcNetbJoKE.edu Asst. Coach Megan Link linkme@SWXdeegxBV.edu Asst. Coach Annette Stromberg stromban@NdaNCcAKig.edu Women's Softball Head Coach Dana Callihan callihad@GgfnpFMtAF.edu Asst. Coach Jen Rivera riverjen@XcjtwOwfKU.edu M/W Swim & Dive Head Coach Andy Boyce boyceand@yjtRISJWtG.edu Head Diving Steve Burciaga burciags@QmUwOgvJfc.edu Asst. Coach Eric Murray murrjame@XRUVlyiccs.edu M/W Tennis Head Coach Samantha Schall schalls@PIYWdHGJft.edu Asst. Coach Austin Hunt huntaus@ZBMwICxoGd.edu M/W Track & Field, CC Head Coach Jerry Baltes baltesj@hUasjOmJqE.edu Assoc. Head Lou Andreadis andreadl@KhaEzrUpuW.edu Asst. Coach Steve Jones jonesteve@dnGdbRjITp.edu Asst. Coach Aaron Watson watsona1@CIjcJiOgGU.edu Asst. Coach Reynaldo Radlin radlinr@MySurDjlsN.edu Asst. Coach Matt Conly conlym@CBQPitddAc.edu 35 Women's Volleyball Head Coach Deanne Scanlon scanlond@hVsNmARkcX.edu Assoc. Head Jason Johnson johnjaso@BLpkIZcUSB.edu 36

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