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.

Blazin Ravenz Track Club Years Played ______

Clearwater Aquatic Team Years Played ______

Clearwater Basketball Club Years Played ______

Clearwater Bullets Years Played ______

Clearwater Jr. Tornadoes Years Played ______

Clearwater Little League Years Played ______

Clearwater Soccer Club Years Played ______

Clearwater Youth Lacrosse Years Played ______

Countryside Jr. Cougars Years Played ______

Countryside Little League Years Played ______

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