Presidential Scholars Honors Application

PRESIDENTAL SCHOLARS HONORS APPLICATION
Presidential Scholars is an honors program that provides a select group of high-achieving students with an unique educational experience designed to prepare them for success at the university of their choice. This program challenges students with increased academic rigor, enrichment activities outside the classroom and an engaging cohort of fellow students.

Please fill out the following information and make sure to send the required Recommendation Form to your references.
GENERAL INFORMATION
Name*

First NameLast Name
Preferred Name*
High School Name*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Intended major at your four year college?*
If unsure, type Undecided
Where do you plan to transfer to after York Tech?*
If unsure, type Undecided
How did you hear about this program?*
If other, please specify:
ACTIVITIES
List high school accomplishments such as awards, clubs/organization memberships, etc.*
List your most rewarding volunteer, community organization service, or job-related experience and explain its significance in your life.*
RECOMMENDATIONS

Please list the name of two professional contacts that you will request recommendation from - one must be a current of former teacher.
Recommendation 1*

First NameLast Name
Recommendation Title*
Relationship to student*
Current/Former teacher, supervisor, etc.
Recommendation 2*

First NameLast Name
Recommendation Title*
Relationship to student*
Current/Former teacher, supervisor, etc.
DISCLAIMER AND SIGNATURE
I, the undersigned, do hereby consent and agree that York Technical College, its employees, or agents have the right to take photographs, videotape, or digital recordings of me to use in any and all media, now or hereafter known, and exclusively for the purpose of displaying the achievements of York Technical College. I further consent that my name and identity may be revealed therein or by descriptive text or commentary.

I do hereby release to York Technical College, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.

I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.

I also understand that York Technical College is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result.

I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.

I certify that my answers are true and complete to the best of my knowledge.
Signature*

Clear
Today's Date*

MonthDayYear
Today's Date
Should be Empty:

PRESIDENTAL SCHOLARS HONORS APPLICATION

GENERAL INFORMATION

ACTIVITIES

RECOMMENDATIONS

DISCLAIMER AND SIGNATURE