Noble Foundation 2021 Scholarship Application

Welcome to the Beatrice Noble Memorial Speedskating Scholarship Application

Recognizing young speed skaters living with a chronic medical condition

Instructions
The Buffalo Speedskating Club is proud to offer three $1,000 scholarships to speed skaters up to age 18 in the US and Canada who are living with a chronic medical condition. For complete scholarship informaiton please visit our website.
Here are some improtant things you need to do before completing this form:

1) Have a list of the following:

a) Speedskating meets (if any) you have competed in

b) Speedskating camps (if any) you have attended

c) Speedskating clinics (if any) you have attended

2) USS or SSC membership number

3) Have two picture of yourslf (one full face and one speedskating) on hand in JPEG format for this form.

4) A written essay (between 250 and 1000 words). Topic - "how speedskating helps me to manage my chronic medical condition, and what the sport means to me". Have it avialable in a DOC, DOCX, or PDF format for upload, or you can write it within the aplication or copy and paste it.

5) The names and emails of the people you are asking for letters of reccomendation. They must both be outside of your immediate family, and one must be from a speedskating coach or club official.

6) Letter from physician (on letterhead) confirming chronic medical condition diagnosis. Have it avialable in a DOC, DOCX, or PDF format.

7) Be ready to answer medical, speedskating and personal questions about yourself.

8) A parent or guardian avialable to e-sign the application.

IMPORTANT: You can fill the form out all at once, or you can save the form and come back to it latter by opening the Submit tab and clicking on Save. You will be emailed a link to return to your form.

If you are ready, then please begin.

Basic information
1. Basic information

Please fill out the information below.
Full Name *

First Name Last Name
How old are you? *
Birth Date *

Month Day Year
E-mail *
Phone Number *

Area Code Phone Number
Address *

Street Address

Apt/Suite #

City State

Postal / Zip Code Country

Medical Questionnaire
2. Medical Questionnaire

Please answer the questions to the best of your ability.
What is your Chronic Medical Condition? *
At what age did you receive your diagnosis? *
Please upload a letter from your physician (on letterhead) confirming your chronic medical condition diagnosis. In can be in a DOC, DOCX, or PDF format. *

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Letters of Recommendation
3. Letters of Recommendation

Please follow the instructions below.
The next step is requesting two letters of recommendation:

1) Speedskating coach or club official
2) An individual of your choosing outside of your immediate family

We will need the name of all the recommenders, their email, and how long you've known them.

After you've entered their information, it will be your responsibility to contact them and ask them to go to the address bellow and fill out their letter of recommendation.

https://form.jotform.com/bscskate/letter-of-recommendation-2020
Speedskating Coach or Club Official
Their Name *

First Name Last Name
Their E-mail *
Years of Relation *
Individual outside of your immediate family
Their Name *

First Name Last Name
Their E-mail *
Years of Relation *

Speedskating Information
5. Speedskating Information

Please answer the questions to the best of your ability.
How old were you when you began speedskating? *
How and why did you get into the sport? *
What are your short term speedskating goals? *
What are your long term speedskating goals? *
Club *
If not listed, please choose "other and provide us with the name of your club
How many total years have you been a member or this or any other past clubs? *
USS or SSC membership number *
Speedskating honors (if any) you have received
Example: Most improved club skater
Speedskating meets (if any) you have competed in
Meet name and date
Speedskating camps (if any) you have attended
Camp name and date
Speedskating clinics (if any) you have attended
Clinic name and date
Articles (if any) that have been written about you
Please provide the HTML for the article(s) or upload them below.
Article upload. In can be in a DOC, DOCX, or PDF format.

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Article upload. In can be in a DOC, DOCX, or PDF format.

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Article upload. In can be in a DOC, DOCX, or PDF format.

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Photo Upload
6. Now we need a two pictures...

Please upload your photos
Full Face Photo
Speedskating Photo

Essay
Write an essay (between 250 and 1,00 words). Topic - "how speedskating helps me to manage my chronic medical condition, and what the sport means to me"
Did another person help you write your essay? *

Yes No
If yes, what relationship is the person to you?
Upload your essay
write or copy and past your essay here.

Submit
Submitting!
Signature of applicant (please use your mouse or pointing device) *
Parent or guardian's name *

First Name Last Name
Relationship to the applicant *
Signature of Parent or guardian (please use your mouse or pointing device) *
Thank you SO much for taking the time to complete the Beatrice Noble Memorial Speedskating Scholarship Application form. You will recive an email in late March informing you of your application status. Winners will be announced on April 1st.

If you're sure everything is filled out correctly, click the Submit button to send your application on it's way.
Should be Empty:

Welcome to the Beatrice Noble Memorial Speedskating Scholarship Application

1. Basic information

2. Medical Questionnaire

3. Letters of Recommendation

Speedskating Coach or Club Official

Individual outside of your immediate family

5. Speedskating Information

6. Now we need a two pictures...

Submitting!