General Information Form
Participant First and Last Name
*
First Name
Last Name
Participant Email
*
example@example.com
Participant Gender
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Please Select
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
Ethnic Background
*
Asian
Black or African American
Hispanic or Latino/a
Native American or Native Alaskan
Pacific Islander
White or Caucasian
Multi-Racial
Participant Phone Number
*
Please enter a valid phone number.
Current Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian #1 Name
*
First Name
Last Name
Parent/Guardian #1 Email
*
example@example.com
Parent/Guardian #1 Phone Number
*
Please enter a valid phone number.
Parent/Guardian #1 Employer:
*
Parent/Guardian #1 Occupation
*
Parent/Guardian #2 Name
First Name
Last Name
Parent/Guardian #2 Email
example@example.com
Parent/Guardian #2 Phone Number
Please enter a valid phone number.
Parent/Guardian #2 Employer
Parent/Guardian #2 Occupation
Grade Level as of December 31, 2023
*
High School Grade Point Average (Based on a 4.0 scale)
*
Years playing golf
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1
2
3
4
5
6
7+
Participant School Form
Name of current High School:
*
Please Check One:
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Public
Private
Homeschool
Anticipated Graduation Date:
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-
Month
-
Day
Year
Date
Class Rank
*
List any Honors (H) or Advanced Placement (AP) classes you are currently taking:
*
Do you play on your high school golf team?
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Yes
No
ACT and SAT Tests
List the highest scores for each section of the SATs you have taken. You must submit a copy of your test
SAT|Math
SAT| Evidence-Based Reading & Writing
Date SAT Taken
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Month
-
Day
Year
Date
List your ACT composite Score:
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Date ACT Taken
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-
Month
-
Day
Year
Date
Do you plan on retaking any of these test?
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Yes
No
Future SAT Test Date:
-
Month
-
Day
Year
Date
Future ACT Test Date
-
Month
-
Day
Year
Date
College Information
List any college to which you have applied and been accepted:
*
If you have already decided, please list the college you plan to attend:
*
Do you plan to play on your college golf team?
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Yes
No
If yes, have you received a college golf scholarship?
Yes
No
Please select the college scholarships you expect to apply for and receive:
*
Athletic full
Athletic partial
Merit
Local Community
National
None
Please list all monetary awards, grants, and scholarships (athletic, golf, community, etc.) you have already received, including the total amount of each, whether they are one-time or recurring, and the awarding institution:
*
If you know your major or course study, please indicate:
*
Please describe your current career aspirations:
*
School & Community Activities Chart
Please complete the chart below
Dates (from-to)
Hours Per Week
Total Hours
Responsibilities and accomplishments
Extracurricular and school Activities
Community and Volunteer Service
Awards and Recognition
Work for Pay
Short Answer Essays
Your response must be 250 words or less per question.
1. Describe in your own words the value participating in First Tee has had in your life. Tell a story about yourself using one of the Life Skills you have applied (NOT Nine Core Values!). Include examples of personal growth, development of leadership traits, core value enhancement, and golf skill development. How will these lessons help you to succeed in college?
0/250
2. Where do you see yourself in 5-10 years after completing your formal education? Please describe what you envision your occupation being and how First Tee’s Life Skills Experience will have influenced and guided you during this time.
0/250
Video Essay
Jack Stephens once told a reporter: "The skills needed to master this game are the same skills needed to master life, a life full of unseen obstacles and excitement." Tell us what this quote means to you and what it would mean to you to be awarded the Jackson T. Stephens Scholarship. In two minutes or less, create a video addressing this topic. Please email Mblake@thefirstteear.org for directions on how to submit your video.
High School Transcript
Please upload your official high school transcript and copies of your official test scores
File Upload
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Browse Files
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Provide a description of the following in 200 words or less:The applicant family’s financial circumstances including any impediments to paying for college (such as number of dependents in college, etc.)Cost to attend selected college or university (include a breakdown of annual tuition, room & board, fees, books, travel)Scholarships (including athletic), grants and awards to be applied toward the cost of attending college in the Fall of 2024 for all dependents
*
Statement of Understanding
I acknowledge that I am fully aware of and understand the following information: Jackson T. Stephens Scholarship: The Jackson T. Stephens Scholarship offers a one-time $5,000 scholarship to two individuals The funds are paid directly to the college or university of the recipient’s choice. Maintaining a Scholarship:Scholars selected for this award must maintain the required academic performance set forth by the school they choose to attend. If performance falls below this level, the First Tee-Central Arkansas may revoke your this scholarship. Please refer to the individual school’s requirements for more information. Electronic Signature: Under federal law, the parties may execute this document electronically – equaling to the same degree as a handwritten signature – by using the following process to create an electronic symbol signifying intent. The party must fill in their name and date below, signifying your agreement.
Partent(s)/Guardian(s) Signature:
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Todays Date
*
-
Month
-
Day
Year
Date
Participants Signature:
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Todays Date
*
-
Month
-
Day
Year
Date
Applicant Certification
I certify that the above information of this application is true and correct to the best of my knowledge. I further certify that if I knowingly have provided false information in an effort to receive financial assistance, my application will be rejected and I will be disqualified from seeking any scholarships through the Jackson T. Stephens Scholarship. I have read and understand all materials for this program. I agree to furnish any additional information requested of me including, but not limited to, academic and/or athletic pictures, updated transcripts and/or official test scores in a timely manner. Electronic Signature: Underfederal law, the parties may execute this document electronically – equaling to the same degree as a handwritten signature – by using the following process to create an electronic symbol signifying intent. The party must fill in their name and date below, signifying your agreement.
Partent(s)/Guardian(s) Signature:
*
Todays Date
*
-
Month
-
Day
Year
Date
Participant Signature
*
Todays
*
-
Month
-
Day
Year
Date
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