SCHOLARSHIP APPLICATION YEAR: YYYY
PERSONAL INFORMATION
NAME:
ADDRESS:
PHONE: (XXX) XXX-XXXXALTERNATE PHONE: (XXX) XXX-XXXX
DATE OF BIRTH: MM/DD/YYYY
ACADEMICS:
ON A SCALE IN WHICH 4.00 IS THE HIGHEST GRADE, PROVIDE OVERALL
HIGH SCHOOL GRADE-POINT AVERAGE USING THREE DIGITS: #.##
OH A SCALE IN WHICH 4.00 IS 'THE HIGHEST GRADE, PROVIDEGRADE-POINT
AVERAGE FOR YOUR LAST TWO YEARS OF HIGH SCHOOL: #.##
STANDARDIZED TEST SCORES / HIGH SCHOOL CLASS RANKING
(Copy of Standardized Test Scores Should Accompany the Application Submission as a Scanned attachment)
DATE OF TEST': MM/DD/YYYY
VERBAL: ####
MATH: ####
DATE OF TEST': MM/DD/YYYY
VERBAL:####
MATH:####
DATE OF TEST': MM/DD/YYYY
VERBAL:####
MATH:####
CLASS RANK: #### OUT OF A TOTAL OF ##### STUDENTS (##% OF THE CLASS)
LIST UP TO THREE (3) INSTITUTIONS APPLIED TO & ACCEPTANCE STATUS
NAME OF UNIVERSITY / COLLEGEAPPLICATION STATUS
1. Please Input Name HerePlease Indicate Status - Accepted, In Progress etc
2.
3
LIST, IN PREFERENCE, CHOICE OF STUDY AT COLLEGE OR UNIVERSITY
1.
2.
3.
LIST ANY ACADEMIC HONORS / AWARDS / ACHIEVEMENTS
1.
2.
3.
4.
5.
ACADEMIC INFORMATION VERIFICATION: (Signature below represents proper verification of all academic information provided in the “Academics” Section of the Application (where applicable))
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(GUIDANCE COUNSELOR SIGNATURE) DATE
WTAA ATHLETIC PARTICIPATION:
PLEASE COMPLETE THE FOLLOWING INFORMATION ILLUSTRATING YOUR WTAA PROGRAM OR SPORTS PARTICIPATION. WTAA PROGRAMS SHOULD INCLUDE, BUT NOT BE LIMITED TO BASEBALL,SOFTBALL,SOCCER,HOCKEY AND BASKETBALL. PARTICIPATION SHOULD BE LISTED FOR A PROGRAM AS LONG ASIT WAS A WATERFORDTOWNSHIP ATHLETIC ASSOCIATION SPONSORED PROGRAM OR SPORT, WHETHER IN-HOUSE RECREATIONAL, TRAVEL OR OTHER.(Examplesgiven below)
Program / Sport / Year(s)of Participation / Type of Program / Coach Last Name* / Coach Last Name* / Coach Last Name*Baseball / 2005-2010 / In House / North / West / East
Baseball / 2005-2010 / Travel / East
Basketball / 2010 / In House / South
Basketball / 2012 / In House / North
*NOTE: If the applicant had more than 3 Coaches, list the last three coaches associated with the Years of Participation for each Program / Sport
RECOMMENDATIONS:
A MINIMUM OF THREE (3) LETTERS OF RECOMMENDATIONARE REQUIRED BY ALL APPLICANTS. THE LETTERS CAN CONTAIN ANYCOMMENTARYIN REGARDS TO THE APPLICANTS GENERAL ABILITY, JUDGEMENT/DECISION MAKING; CREATIVEQUALITIES, MATURITY, INITATIVE, SELF-DISCIPLINE, LEADERSHIPPOTENTIAL, ANALYTICAL SKILLS,AND VERBAL WRITTEN SKILLS. RECOMMENDATIONS CAN ALSO INCLUDE THE APPLICANT’S ACADEMICPROMISE, CHARACTER AND/OR ANY OTHER PERSONAL COMMENTARY.
(Applicant Needs to Include with Application when emailing Final Submission)
WORK OR OTHER OUTSIDEACTIVITIES:
PLEASE LIST ALL WORK OR OTHER ACTIVITIES & EXPERIENCES.
THIS LIST COULD INCLUDE, BUT NOT BE LIMITED TO, INVOLVEMENT IN THE
BOY SCOUTS, GIRL SCOUTS, NURSES AID, YOUTH GROUPS,SCHOOL CLUBS, HONOR CLUBS, AND AFTER SCHOOL/SUMMER EMPLOYMENT.
(Examples Given Below)
Activity / Year(s)of Participation / Type of Activity / ResponsibilitiesMurphy’s / 2009-2010 / Employment / Cashier / Stock Shelves
Italian Club / 2009-2012 / Academic
Youth Group Mentor / 2010 / Community / Mentor Younger Children in Faith Formation
APPLICANT’S SIGNATURE
MY SIGNATURE BELOW CONFIRMS THE INFORMATION I HAVE PROVIDED IN THIS APPLICATION & IN ALL OTHER ATTACHMENTS SUBMITTED FOR CONSIDERATION FOR THE WTAA SCHOLOARSHIP AWARD IS ACCURATE TO THE BEST OF MY ABILITY.
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(APPLICANT’S SIGNATURE) DATE
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(PARENT / GUARDIAN SIGNATURE) DATE
RETURN ALL FINAL APPLICATION DOCUMENTATION WITH THE PROPER SIGNATURES & ATTACHMENTS BY MAY 1STTO