Clearwater for Youth Application - 2017

Ø  Date: ______

Ø  Name: ______

Ø  Address:______

Ø  Email Address: ______

Ø  Contact Phone Number: ______

Ø  What High School do you currently attend? ______

Ø  What is your overall GPA______

Ø  What was/is your ACT or SAT score? ACT: ______SAT: ______

Ø  Percentage of Bright Futures for which you qualified? ______

Ø  What organizations have you worked with doing community service?

o  ______How Long? ______

o  ______How Long? ______

Ø  What leadership roles have you taken in your community and school?

o  ______

o  ______

o  ______

o  ______

Ø  Please list your High School sports and the years in each:

SPORT / FRESHMAN / SOPHOMORE / JUNIOR / SENIOR / CAPTAIN
YES/NO
BAND
BASEBALL
BASKETBALL
CHEERLEADING
DRAMA
FOOTBALL
GOLF
LACROSSE
SOCCER
SOFTBALL
SWIMMING
TRACK
VOLLEYBALL
OTHER

Ø  Please list any other High School Academic/Sports accolades you would like CFY to consider:

o  ______

o  ______

o  ______

o  ______

Ø  Please identify or list any CFY supported or City sports you have played other than High School Sports. Designate the organization (s) and number of years you played each sport.

o  Blazin Ravenz Track Club Years Played ______

o  Clearwater Aquatic Team Years Played ______

o  Clearwater Basketball Club Years Played ______

o  Clearwater Bullets Years Played ______

o  Clearwater Jr. Tornadoes Years Played ______

o  Clearwater Little League Years Played ______

o  Clearwater Soccer Club Years Played ______

o  Clearwater Youth Lacrosse Years Played ______

o  Countryside Jr. Cougars Years Played ______

o  Countryside Little League Years Played ______

o  Greenwood Panthers Years Played ______

o  Other: ______Years Played ______

Ø  Please list in order of preference the top 3 colleges in which you have applied:

1. ______

Accepted______or Waiting for notification______

2. ______

Accepted______or Waiting for notification______

3. ______

Accepted______or Waiting for notification______

·  You must include an ESSAY with your Clearwater for Youth Application. The topic of the essay is: “What would receiving the Clearwater for Youth Scholarship mean to you and your pursuit of higher education?” - essay should be no longer than 1 page.

Ø  This application must include a signature from your school Guidance Office, Athletic Director or Principal.

Applicant Name (Printed): ______

Applicant Signature: ______Date: ______

Guidance Officer/Athletic Director/Principal Name (Printed): ______

Guidance Office/Athletic Director/Principal Signature:

______Date: ______

State position at school:______

Contact Number: ______

CFY ApplicationPage 4