River Cities Scholars Application

Student Information

Dear Families, The members of the faculty and staff of Holy Cross District High School are interested in helping your child experience academic success. Please provide answers to the following questions and add any comments that you feel are important for us to know.
Does your student have a diagnosed learning disability?*

YesNo
If yes, please provide the following information below: Diagnosis, Diagnosis Date, and Date of Most Recent Assessment
If yes, who provided the diagnosis?

PhysicianPsychiatristPsychologistOther
Does your student currently have an IEP or ALP?*

YesNo
If your student currently has an IEP or ALP please send all relevant documentation to our Academic Enhancement Coordinator, Ms. Megan Bosma.

All documentation, questions, and inquiries related to learning disabilities and Academic Enhancement can be sent to megan.bosma@hchscov.com
If the student has any allergies, please list them down below:
Does the student have any medical conditions that you would like to declare?

River Cites Scholars

Additional Questions
Current GPA
(If applicable)
School and Community Activities
Please list and describe any school or community activities, including position(s) or role(s) held and grade level.
Honors and Awards
Please list and describe any honors or awards received including grade level.
Student Essay*
Please complete a small essay (100-150 words) explaining why you should be selected for the River Cities Scholars Program. Type your essay above or upload a file below. Some Ideas for Your Essay: What is your goal in life? What do you hope to be when you graduate high school? How do you perceive that you are a leader? What types of service activities have you participated in? How did the service impact you? Why are you interested in becoming a River Cities Scholar?
Personal Essay Upload

Please upload your essay here, if you did not write it above.
Cancelof
Letter of Recommendation (Optional)
A teacher, counselor, or mentor may provide a brief recommendation. Not having a letter will not negatively impact a potential scholar. Please include the name of the recommender and relationship to the student. The letter can be typed above or uploaded below.
Letter of Recommendation Upload

If you have a saved letter of recommendation, please upload it here.
Cancelof
Next Steps
FACTS TUITION SETUP. Families applying for the River Cities Scholars Program need to apply for financial assistance through the FACTS system. Setup a FACTS account HERE.

Hannah Knox, the River Cities Program Director, will reach out once your application has been received and reviewed by the River Cities Scholars Board Members. Selected students and their parent(s)/guardian(s) will need to complete an interview to move on. Mrs. Knox will contact you with a few dates and times for the interview.

After the interview process, Mrs. Knox will be in contact to discuss next steps.

For any questions, please contact Hannah Knox at hannah.knox@hchscov.com or call 859-431-1335.
Parent/Guardian Signature

Clear
Parent / Guardian
Date Signed

MonthDayYear
Date
Should be Empty:

River Cities Scholars Application Form

Parent or Guardian #1

Parent or Guardian #2

Emergency Contact(s)

Student Information

River Cites Scholars

Next Steps