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SOU High School Scholars

Application

Due to AHS Main Office by 4:00PM Monday, April 13, 2009

Name:______Grade 2009-2010: 11th

Date of Birth : ______Gender:  Male  Female

MM/DD/YYYY

Contact Information:

Applicant’s Address:______

Street Address

______

CityState Zip

Applicant’s Phones: (Cell)______(Home)______

Applicant’s Email:______

Parent/Guardian Name(s):______

______

Parent/Guardian Contacts: (Cell)______(Work)______

(Home)______Email:______

Parent/Guardian & Student Assurances

We have read the profile of a successful student and support this application.

Our family is financially responsible for the tuition and textbook charges.

We acknowledge that accceptance into the SOU/AHS program means that the applicant cannot change classes later in the fall term.

We understand that grades earned in the program become part of the applicant’s permanent AHS and college transcripts.

We understand that the applicant will be on SOU’s campus for a class. Neither AHS nor SOU is responsible for student safety going to and from SOU’s campus. Transportation is not provided.

We acknowledge that taking a class on a college campus means that attendance will not be supervised and students will be in classes with adults of all ages.

______

Parent/Guardian SignatureDate

______

Student SignatureDate

REFERENCES

List three references that can give the selection committee information about your academic ability and your social/emotional maturity. At least one reference must be one of your current high school teachers.

Name / Relationship to Applicant / Phone Number

ESSAYS

Please submit a typed essay on each topic below.

Each essay must be no more than one page, using 12-point font and 1.5 lines spacing, for a total of two pages.

Topic One:

Why do you want to join the SOU High School Scholars and what strengths will you bring to the program?

Topic Two:

Describe a time in your life when you had to operate at a higher level than your peers. How did you accomplish that?

SUPPORTING DOCUMENTATION

Upon receipt of the application Ashland High School will provide the committee with these documents for each applicant. Applicants do not need to request them.

  • AHS Transcript
  • State Assessment Results
  • PSAT/ SAT/ AP Results
  • Attendance and Discipline Records

Ashland Contact for SOU High School Scholars:

Michelle Zundel, Director of Educational Services,

482-1611 x173

Over Please 