Wjsc Scholarship Program

WJSC SCHOLARSHIP PROGRAM

2018 APPLICATION FORM

Due 4/30/18

(TYPE OR PRINT)

1. APPLICANT’S PERSONAL INFORMATION

NAME:______

STREET ADDRESS:______

CITY, STATE, ZIP CODE:______

HOME TELEPHONE:______

SOCIAL SECURITY NUMBER:______

DATE OF BIRTH:______AGE:______

CURRENT HIGH SCHOOL:______

2. SOCCER INVOLVEMENT:

a. WJSC PARTICIPATION - PLAYER (MINIMUM 1 SEASON)

YEAR(s):______PROGRAM (ie U6, U8, U9 & above):______

YEAR(s):______PROGRAM(ie U6, U8, U9 & above :______

(USE ADDITIONAL SHEETS IF NECESSARY)

b. OTHER SOCCER PARTICIPATION - PLAYER (Junior or Senior High School Level or Premiere Team)

YEAR(s):______SCHOOL:______TEAM:______

(USE ADDITIONAL SHEETS IF NECESSARY)

c. SOCCER RECOGNITION (USE ADDITIONAL SHEETS IF NECESSARY)

(List any School, City, State or National Awards - e.g. First Team - All State)

______

3. ORGANIZATIONS AND ACTIVITIES (USE ADDITIONAL SHEETS IF NECESSARY)

(List your participation in Scholastic Activities or Civic Organizations). (Indicate any offices you held.)

YEAR(s):______ORG:______OFFICE:______

4. HONORS AND AWARDS (USE ADDITIONAL SHEETS IF NECESSARY)

(List any honors or awards presented to you. Include the year and organization.)

______

5. ADDITIONAL INFORMATION (USE ADDITIONAL SHEETS IF NECESSARY)

(Provide any additional information you may believe is relevant.)

______

6. FUTURE PLANS AND GOALS (USE ADDITIONAL SHEETS IF NECESSARY)

(Provide a brief description of your college plans and any goals you have set for your life.)

______

7. APPLICANT’S STATEMENT (USE ADDITIONAL SHEETS IF REQUIRED)

(Explain why you applied and why you think you should receive this scholarship.)

______

8. REFERENCES (USE ADDITIONAL SHEETS IF REQUIRED)

(List the people who will provide references.) (A minimum of 3 is required.) (Use the form letter provided.)

1.______

2.______

3.______

9. Overall GPA ______

I verify that the information provided is accurate and correct to the best of my knowledge.

______

SIGNATURE OF APPLICANT DATE

Please submit application by 4/30/18 to the following address:

WJSC

RE : Scholarship Form

PO Box 7085

Wyomissing, PA 19610

WJSC SCHOLARSHIP REFERENCE / LETTER OF RECOMMENDATION (due 4/30/18)

(Please type or print clearly)

To: WJSC Board

PO Box 7085

Wyomissing, PA 19610

Recommendation for:______

(Name of Applicant)

From:______

(Person providing the recommendation)

Address:______

Phone: ______

Relationship to the Applicant:______

How long have you known the applicant?______

Please briefly explain why you would recommend this person for this scholarship. Since good

character, citizenship and sportsmanship weigh heavily in the consideration process, if you can,

please provide some examples of these traits that you have observed in this person. Attach

additional sheets if necessary.

Signed:______

Date:______