(TO BE COMPLETED BY: Applicant)
CENTRAL COAST SECTION SCHOLAR-ATHLETE SCHOLARSHIP AWARD
STUDENT APPLICATION FORM (PART A)
Please evaluate the prerequisites and qualifications for this award on the previous pages. If you meet the requirements, you are invited to complete and submit this application. The entire application packet [the Student Application Form: Parts A & B; a transcript of grades verifying the information given; an official verification of SAT/ACT score(s); your essay; and all letters of recommendation] must be physically received in the CCS Office, 6830 Via Del Oro, Suite 103, San Jose, CA 95119, by no later than 3:30pm, FRIDAY, MARCH 07, 2008.
(ATTACH ADDITIONAL PAGES IF SPACES PROVIDED ARE NOT SUFFICIENT)
*** GENERAL INFORMATION SHEET ***
| APPLICANT:__________________________________ | AGE:______ | MALE:______ | FEMALE:_____ | |
| ADDRESS:______________________________ | CITY:____________________ | ZIP:_______________ | ||
| PHONE#:_______________________________ | HIGH SCHOOL:___________________________________ | |||
| I HAVE
BEEN ACCEPTED TO THE FOLLOWING
UNIVERSITIES/COLLEGES:__________________________ ___________________________________________________________________________________________ |
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| I AM INVOLVED IN THE FOLLOWING SCHOOL ACTIVITIES (Include length of involvement for each): | ||||
| ___________________________________________________________________________________________ ___________________________________________________________________________________________ |
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| COMMUNITY SERVICE IS A PART OF MY SCHOOL'S GRADUATION REQUIREMENT: NO YES (hrs?___) | ||||
| I AM INVOLVED IN THE FOLLOWING COMMUNITY ACTIVITIES (Include total hours of involvement for each): | ||||
| ___________________________________________________________________________________________ ___________________________________________________________________________________________ |
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NON-ATHLETIC AWARDS/ACHIEVEMENTS:_____________________________________________________ ___________________________________________________________________________________________ |
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(TO BE SIGNED BY: Administrator)
*** STUDENT'S CITIZENSHIP VERIFICATION FORM ***
As part of the process for selecting CCS Scholar/Athlete Scholarship Award winners, this student's Citizenship Verification Form must be carefully considered and signed by the student's school administrator:
I certify that _________________
demonstrates integrity, fair-play and good citizenship,
both in and out of the competitive arena; that he/she is an honest individual;
that he/she
is a positive role model for others; and that he/she is clearly an exemplary
sportsperson.
____________________________
___________________________
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SCHOOL ADMINISTRATOR'S
SIGNATURE
TITLE
DATE