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First Name
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Middle Initial
Last Name
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Sex
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Please Select
Male
Female
Street Address
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Street Address
Street Address Line 2
City
State
Zip Code
Email Address
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Phone Number
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Date of Birth
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-
Month
-
Day
Year
Date
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Parent / Guardian
First Name
Last Name
Parent / Guardian Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent / Guardian Phone Number
Please enter a valid phone number.
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Name of High School
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Cumulative GPA (4.0 Scale)
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Class Rank
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Please Select
Top 1%
Top 10%
Top 25%
Below 25%
None
Percentage of Honors, AP, or Dual Credit classes
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Please Select
100%
75% - 99%
50% - 74%
25% - 49%
01% - 24%
None
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List any academic honors, awards, or membership activities while in high school
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List your hobbies, outside interests, extracurricular activities and school related volunteer activities
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List your non-school sponsored volunteer activities in the community
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Leadership Activities: List the level of responsibility in school, community, family, and your ability to influence others
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Work Experience
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Have you decided on the college you will attend?
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Yes
No
College Choice
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College Choice #2 (if undecided)
College Choice #3 (if undecided)
Anticipated Field of Study
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Community Service Essay
Describe how your community service came about and what being a volunteer has taught you. Which causes or organizations especially interest you and why? Finally, discuss any challenges you have dealt with and overcome and how this will help you succeed in college and beyond (400-600 words).
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Select a partner organization for the matching contribution.
If chosen as the scholarship recipient, I understand that I will receive a $500 check in my name and a $500 contribution will be made to the following organization in my name
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Angel Tree (helmets provided to underprivileged children receiving a bike/scooter/skateboard from the Salvation Army)
Bike Rodeo (helmets provided to underprivileged children participating in a local elementary school bike rodeo)
Blue Santa (helmets provided to underprivileged children receiving a bike/scooter/skateboard from the SAPD)
Earn-A-Bike Co-Op (helmets provided to underprivileged children receiving a bike from Earn-A-Bike)
Morgan's Wonderland/STRAPS (support the power wheelchair soccer program)
YMCA (helmets provided to underprivileged children through the YMCA)
You may choose from local organizations supporting bicycle safety or local soccer programs.
Bicycle Safety
Soccer Programs
BICYCLE: If chosen as the scholarship recipient, I understand that I will receive a $500 check in my name and a $500 contribution will be made to the following organization in my name to provide helmets to those in need.
Angel Tree (underprivileged children receiving a bike from The Salvation Army)
Bike Rodeo at local elementary school
Blue Santa (underprivileged children receiving a bike from the SAPD)
Reindeer Brigade (underprivileged children receiving a bike from the Boys and Girls Clubs of SA)
YMCA Skate Parks
SOCCER: If chosen as the scholarship recipient, I understand that I will receive a $500 check in my name and a $500 contribution will be made to the following organization in my name to allow underprivileged players a chance to play organized soccer.
Buffalos FC
Bulverde Youth Soccer Association
Classics Elite
i9
Morgan's Wonderland/STRAPS (Power Wheelchair Soccer)
NEYSO
SA United
San Antonio City
STING
YMCA
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Please check the following box to confirm you are ready to submit your application.
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I have reviewed all my answers and I am ready to submit my application for review.
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