ICCA Scholarship Application
Please TYPE your information on this form. This form, along with the other required materials, must be postmarked
no later than Monday, December 1, 2014 in order to be considered. Do not apply unless you can be in attendance for the
interview (January 2, 2015) and award ceremony (January 3, 2015). Member schools/individual members only.
PARTICIPATION INFORMATION
______
Participant Name Date Participant Signature Date
______
Participant Address Participant City/State /Zip Code
Home Phone Number ______Cell Phone number ______
E-mail Address ______
Parent/Guardian Names ______
Name of High School ______
******Official School Transcript Required with School Stamp or Seal******
Winter sport cheering ______
College/Universities of Interest (Please indicate those at which you have been accepted)
______
______
Intended Major/Minor ______
Will you cheer in college? ______
COACH’S INFORMATION
As coach of the applicant, I certify that the candidate is a student in good standing within his/her school. This candidate is
in compliance with all IHSA/ICCA cheerleading eligibility rules.
______
Coach’s Name Date Coach’s Signature Date
E-mail Address______
Home Phone Number ______Cell Phone Number ______
Coach: Please complete the coach’s questionnaire from your cheerleader’s application and send it in a separate sealed envelope
to: Cindy Rueter, 630 Lakefield Drive, Columbia, IL 62236.
Instructions
All information must be postmarked and sent to Cindy Rueter by Monday, December 1, 2014. Incomplete information, unacceptable video format, or those not postmarked by the deadline will NOT be considered. Please direct all questions to Cindy Rueter. Finalists will be notified by letter and the interview process will be at the ICCA Championships on Friday, January 2, 2015.
Video Instructions (DVD only)
1. Applicant must be in uniform. Others in stunt groups must be in practice clothing.
2. All skills are to be shown in the following order.
3. Video must include:
Ø Cheer - You may incorporate tumbling/jumps but NO stunts.
Ø Dance - Show at least five 8-counts which may include tumbling/jumps but NO stunts.
Ø Jumps - Demonstrate a toe touch, double toe, pike and hurdler.
Ø Tumbling - Show a standing back handspring and round off back handspring-minimum! Any additional passes or standing skills are welcome.
Ø Stunts - Extension and Liberty - minimum! Please demonstrate two additional stunts. Full twist dismounts are highly encouraged. You may be the flyer, base or back, but no front spots please.
***WITH ALL STUNTS AND TUMBLING, PLEASE FOLLOW THE NATIONAL FEDERATION GUIDELINES WITH REGARDS TO WHEN A MAT IS NEEDED***
Checklist
_____ Application (typed). If you can’t type directly on the form, copy the application as a word document
and type on it.
_____ Coach’s questionnaire (Coach sends separately in a sealed envelope)
_____ Official transcript sealed in an envelope with registrar’s signature and school seal (Need GPA and
ACT/SAT scores). This envelope can be sent with application and dvd, but needs to be sealed.
_____ Cheer skills video (dvd ONLY) *WILL NOT be returned*
Put the video in a paper sleeve with your name and school on the sleeve.
_____ Individual photo (wallet size, headshot only and you must be in uniform) *WILL NOT be returned*
Put your name on the back of the picture and put it in the paper sleeve which contains your video.
Finalists’ photos will be used for the program.
Your envelope packet should have: application, sealed official transcript, and video. Put your dvd in a paper sleeve with your name on the sleeve and your picture in the sleeve.
ICCA Scholarship Assessment
I. Weighting/Value for all Assessed Areas
a. Academic Achievement – 40 points
i. GPA – Non-weighted only – 35 points
1. multiplier
a. Multiply GPA from 4.0 scales by 8.75
b. Multiply GPA from 5.0 scales by 7
2. ACT/SAT – 5 points
ACT SAT
a. 5 35-36 1530-1600
b. 4.5 33-34 1450-1520
c. 4 31-32 1360-1440
d. 3.5 29-30 1280-1350
e. 3 27-28 1200-1270
f. 2.5 25-26 1130-1190
g. 2 23-24 1050-1120
h. 1.5 21-22 970-1040
i. 1 19-20 890-960
j. .5 under 19 under 890
b. Cheerleading Skill Video – 40 points
i. Voice – 5 points
Articulation/volume/pacing
ii. Motions – 5 points
Placement/execution/sharpness
iii. Dance – 5 points
Rhythm/timing/execution
iv. Jumps – 5 points
Flexibility/execution/form/height/landing
v. Stunts – 5 points
Difficulty/execution/technique
vi. Tumbling – 5 points
Difficulty /execution/technique
vii. Creativity/Originality – 5 points
viii. Overall Appeal – 5 points
Enthusiasm/energy/facials/appropriateness
c. Coach’s Questionnaire – 20 points
Cindy Rueter
630 Lakefield Drive
Columbia, IL 62236
618-570-9994
Coach’s Questionnaire for Scholarship
Scholarship Applicant ______
Coach’s Name ______
Coach’s Phone number ______
Coach’s Email ______
Rate this athlete on a scale from 1 to 10 with 10 being the highest (can use 0.5 if needed).
1. This athlete shows leadership on your team.
1 2 3 4 5 6 7 8 9 10
2. This athlete is coachable and cooperates with the coach.
1 2 3 4 5 6 7 8 9 10
3. This athlete is a team player and works well with all members of the squad.
1 2 3 4 5 6 7 8 9 10
4. This athlete represents your school as a responsible citizen.
1 2 3 4 5 6 7 8 9 10
Coach - Please complete this questionnaire and send it in a separate sealed envelope to:
Cindy Rueter, 630 Lakefield Drive, Columbia, IL 62236.