STATUS Scholarship Application Form

STATUS Scholarship Application (2023)

The information provided on this form will be used by the STATUS Scholarship Committee to select this years scholarship recipient. It is important that you give complete details concerning your college/career plans, and activities.
BASIC INFORMATION
Student's Full / Legal Name*

First NameLast Name
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Phone Number*

Area CodePhone Number
Student E-mail*
example@example.com
Student Birth Date

MonthDayYear

Academics
Academic GPA*
Schools to which you are applying
School 1
School 2
School 3
School 4
School 5
School 6
Will Live
Major(s) You Are Considering

In order of preference, list the major(s) you are considering (Very important for scholarship eligibility).
Major 1
Major 2
Major 3

REFERENCES:

Please list one educator and at least one community person who would recommend you for a scholarship. Please do not list the person who completes a scholarship recommendation for you.
Reference 1 Name (Position,Phone Number)
Reference 2 Name (Position,Phone Number)

SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

List name of club, etc. and years of participation. If you volunteered, list the name of organization and the number of hours, weeks and years that you volunteered. If you worked, list the company, hours per week and length of time. Attach an additional sheet or resume if necessary.
Varsity Sports Participation 1
Varsity Sports Participation 2
Varsity Sports Participation 3
School Activities / Offices Held : (not sports)
School Activities / Offices Held : (not sports)
School Activities / Offices Held : (not sports)
Community Service / Volunteer Activities 1 (outside of school)
Community Service / Volunteer Activities 2 (outside of school)
Community Service / Volunteer Activities 3 (outside of school)
Will you be participating in a sport(s) in college?

YesNo
What Sport?
School / Community Awards and Honors 1 (no matter how small) CSF, GSE, National Honor Society, Girl/Boy Scouts, 4-H, Governor’s Scholar, etc.
School / Community Awards and Honors 2
School / Community Awards and Honors 3
EMPLOYMENT 1: List past and present work and length of time employed.
EMPLOYMENT 2: List past and present work and length of time employed.
EMPLOYMENT 3: List past and present work and length of time employed.

SCHOLARSHIP RECEIVED TO DATE 1
AMOUNT 1
SCHOLARSHIP RECEIVED TO DATE 2
AMOUNT 2
What was the biggest lesson you learned through sports? How will you apply this lesson in college?*

0/500
Student-Athletes Taking Action to Universally Succeed
Submission Time

MonthDayYear
DateHourMinutesAM/PM Option
Should be Empty:

STATUS Scholarship Application (2023)