2016

Grapevine-Southlake Soccer Association

Scholarship Application

The Grapevine-Southlake Soccer Association annually grants $1,500 Nick Borkowski Scholarships and $1000 John A Borszich Scholarships. The Scholarshipsare available to High School Juniors and Seniors planning to attend, or students currently attending, an accredited two or four-year college, university, trade or technical school. Applicants must have participated in GSSA as a player, coach, referee or assistant referee. Scholarships are awarded based on academic performance, extra-curricular activities, personal goals, and essays.

Name of Applicant______

Telephone______Email______

Address ______

HighSchool______High School GPA ______Class Rank______

Expected Date of Graduation ______of College Enrollment ______

SAT Scores ______ACT Scores ______

College, University, Trade, or Technical School Attending/Planning to Attend ______

Anticipated Major Field(s) of Study ______

GSSA Participation (markall that apply and indicate the dates or seasons of participation):

Player______Dates/Seasons______

Coach______Dates/Seasons______

Referee______Dates/Seasons______

Asst. Referee______Dates/Seasons______

Board Member______Dates/Seasons______

Volunteer______Dates/Seasons______

Please list volunteer activities: ______

Application Instructions

1. Submit the following with this application:

  1. An essay of 500 words or less describing your goals and how your GSSA experience will help achieve those goals. Please include how this scholarship will help achieve your goals.
  2. Completed Application and information sheets (attached)
  3. School transcript(s)
  4. Teacher Evaluation Form (attached)

2. I understand that the selection of this scholarship is based upon:

  1. Participation in GSSA
  2. Applicant’s essay
  3. Scholastic / academic achievements
  4. Involvement in school and community activities
  5. Teacher recommendation

3. I understand that if I receive this scholarship, the funds will be applied to educational expenses (sent to the school, college, or university registrar’s office). If I see that I cannot attend school or drop out before completion of the first semester, I will forfeit my scholarship.

4. I understand that if awarded multiple scholarships, they are to be used concurrently, not simultaneously.

4.Mail or deliver application to GSSA Scholarship, 1001 W Northwest Hwy, Suite D, Grapevine, 76051

MUST BE RECEIVED COMPLETE BY March 15, 2016

Date ______Applicant’s Signature______

Signature of Parent of Guardian ______

Scholastic / Academic Achievement

List of Awards / Achievements:

(Honor Society, Texas Scholar, National Merit Finalist, Band, Sports, etc.)

______

______

______

______

______

______

Involvement in School and Community Activities

Grade Activity or Organization Office or Duties

______

______

______

______

______

Work Experience

EmployerDatesResponsibilities

______

______

______

______

______

Hobbies and Interests

______

______

______

______

______

______

Essay

In 500 words or less, describe your goals and how college will help prepare you for a career. Please include how this scholarship will help achieve your goals.

Teacher Evaluation

Student’s Name ______

How long have you known the student? ______

Teacher’s Name ______School ______

Subjects ______

Scholastic Record: ______

Dependability: ______

Leadership: ______

Participation: ______

Cooperation: ______

Other Comments: ______

Teacher’s Signature ______Date ______