Social Justice Award (SJA)

Social Justice Award (SJA)

The information provided on this form will be used by the CDA Committee to select recipients for scholarships. It is important that you give complete details concerning your debate history, activities and financial information.
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*
Student Birth Date

MonthDayYear
Gender
Academics
High School GPA of of 4*
Weighted GPA
Unofficial Transcript*

Browse Files

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SAT/ACT Score Report

Browse Files
Optional Cancelof
Major(s) You Are Considering

In order of preference, list the major(s) you are considering.
Major 1
Major 2
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. email)
Reference 2 Name (Position,Phone Number, email)

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.
School Activities (not sports)
School Activities (not sports)
School Activities (not sports)
Community Service / Volunteer Activities 1 (at school)
Community Service / Volunteer Activities 2 (outside of school)
Community Service / Volunteer Activities 3 (outside of school)
Sports Participation 1
Sports Participation 2
Will you be participating in a sport(s) this year?

YesNo
Travel Experience or Unusual Experiences (study abroad, etc.)
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.

Parent Financial Information

You will need to make available a copy of the first page of your most recent tax return and you must complete the information requested below. All information supplied by you will be treated as confidential. If your financial circumstances change after you have submitted this form, please feel free to contact us. Complete this entire page if you want your student to be considered for need-based scholarships.
Directions

Stepparent information may replace Mother or Father's information: Please report earnings for the parent/stepparent who the student has lived with most of the time (over 50%) in the past twelve months. If the student lives with both parents equally then provide answers about the parent/stepparent who provides the most financial support.
Father/Stepfather/Guardian Name*
Father/Stepfather Employer and Occupation*
Mother/Stepmother/Guardian Name*
Mother/Stepmother Employer and Occupation:*
Number of dependents in home:*
Father/Stepfather Annual Income :*
Mother/Stepmother Annual Income :*

BASIC INFORMATION