SADD NATIONAL COLLEGE SCHOLARSHIP

APPLICATION FORM 2016

Application packages must be returned by April 15, 2016

Type directly into this form, then save with your name in the document title.

Name: Male Female

Address:

City: State: Zip:

Date of Birth:Current Year in School:

Email address: CellPhone:

Parent/Guardian Name: Parent or Guardian Email:

CurrentSchool Name:

CurrentSchool Address:

CurrentSchoolCity: State: Zip:

School Telephone:

SADD Advisor: SADD Advisor Email:

College/University you will be attending in the Fall (if known):

College/University Address:

City: State: Zip:

Anticipated Year of College Graduation: Expected Major (if known):

I certify that I have provided complete and accurate statements on this application. My typed signaturebelow indicates that I will be a full-time college student in the 2016-2017academicyear, and I grant SADD, Inc. the authority to verify this information. I understand that all documents submitted in supportof this application become the property of SADD, Inc.and that they may be used for publicity and promotional purposes. I agree that if I am selected for a scholarship award, my name, photograph, and any materials submitted with this application may be used for publicity with no compensation by SADD, Inc.

Signature Date

(Typing your name serves as your legal signature)

Return to: or

SADDCollege Scholarship

SADD, Inc.

255 Main Street, Suite 208

Marlborough, MA01752

Email Submission or Application Postmark Deadline: Friday, April 15, 2016

SADD NATIONAL COLLEGE SCHOLARSHIP

APPLICANT’S PERSONAL STATEMENT

Write a brief statement describing your commitment to SADD and a safe and healthy lifestyle. You may comment on your motivation to join and remain a part of SADD, any struggles you have had in your chapter or in your own life and how you resolved them, how you have spread the word about SADD, how you have been a leader in your chapter or any other topic you feel may highlight your commitment to SADD and SADD’s goal of advancing peer-to-peer education, prevention and activism. Include specific anecdotes or examples to explain why you should receive a SADD National College Scholarship.

Applicant’s Name:

Signature: Date:

(typed signature is acceptable for electronic submission)

SADD NATIONAL COLLEGE SCHOLARSHIP

APPLICANT’S ACTIVITY SUMMARY

Please list each activity, organization, team, club, service project or group with which you are involved. If you have a résumé with comparable information, you may submit it in place of this form.

Club, Team, Group or Organization / Nature and extent of involvement
(offices held, work done, etc.) / Years Involved

You may photocopy or copy and paste this form, if more space is needed.

Applicant’s Name:

Signature: Date:

SADD NATIONAL COLLEGE SCHOLARSHIP

CHECKLIST

Please make sure that you’ve completed, included, and/or confirmed all of these

items before you send in your application!

Completed Application Form

Two Applicant Recommendations (electronic submission preferred; forms can be downloaded at )

Personal Statement

Activity Summary

One copy, if submitting by email;original application

andone photocopy,if submitting by mail. Emailcopy

encouraged. Due to SADD, Inc. by April 15, 2016.

I have confirmed that my SADD Chapter is currently

registered as of this school year and my advisor has a

Certificate of Chapter Recognition dated after 7/1/15.