Name

First Name

Last Name

Athletic Activities

Please list the following information for each of your athletic activities. Activities could include sports, dance, or anything else you interpret as athletic. • Activity name • How many years have you done this? (Ex: 2018-2025) • Have you received any awards or recognition related to this activity? • Coach’s name • Coach’s contact information We may contact your coach to verify your involvement in the athletic activity, so please give them a heads up. If you do not have a coach or teacher for the activity, you may leave it blank.

Written Statement

If you would like to provide additional information about your athletic activities and academic record, please do so below. Please limit yourself to 250 words.

Thank you for applying for the Scholar Athlete Award. We will announce the winners onstage in March. Good luck!

Scholar Athlete Application

Please complete the form below to be considered for the Scholar Athlete Award and scholarship.