IHSSDHOF / INSKEEP SCHOLARSHIP
APPLICATION
FORM
A valid application should include the
following:
·
A
completed application form
·
Official
Transcript
GENERAL
INFORMATION
Name
_____________________________________________________________________
Address
__________________________________________________________________
City (Zip)
__________________________________________________________________
High School
_______________________________________________________________
High School
Principal Name _________________________________________________
Parent/Guardian____________________________________________________________
Sport for which applying for scholarship:
______________________
List the sports and years the applicant
participated ______________________________
__________________________________________________________________________
__________________________________________________________________________
List the letters received in each sport
__________________________________________
__________________________________________________________________________
__________________________________________________________________________
Would this award impact any other financial
award that you have already received?
____________________________________________________________________________
____________________________________________________________________________
College Preference and Area of Pursuit
__________________________________________
By
signing this form, I confirm the following:
1. I have remained substance free, and pledge to
remain substance free, throughout my high school career
2. I have never been ejected from a contest for
unsportsmanlike conduct
3. I have never violated my school’s code of
conduct
4. I confirm that the information listed above
is accurate
Student’s Name (print)_______________________________________
Student’s Signature
_________________________________________
Date _______________________
Parent’s Name (print)________________________________________
Parent’s Signature
__________________________________________
Date _______________________
IHSSDHOF
/ INSKEEP SCHOLARSHIP
APPLICATION FORM
I. ACADEMICS (attach certified transcript)
High School GPA (on a
4.00 scale) ________
Class
Rank _____ out of a total enrollment of _______.
Does
the school offer advance placement or honors classes?
(yes/no)
_______________
Did
the applicant enroll in these advance placement or honors classes?
(yes/no)
_______________
If
yes, is the applicant’s GPA weighted?
(yes/no)
______________________________
SAT/ACT
Scores _______________________
II. EXTRA-CURRICULAR ACTIVITIES
Applicants: On this form, list the most significant
out-of-classroom activities you have been involved in. Those activities would include those which
last through a sports season, semester, or school year, as opposed to those
activities which are conducted once a year on a single day or weekend. When listing awards, please list the most
significant awards in the comments area provided.
SCHOOL
ACTIVITIES Grades Participated
9 10 11 12
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Awards/Leadership Positions/Comments:
IHSSDHOF
/ INSKEEP SCHOLARSHIP
APPLICATION FORM
COMMUNITY
ACTIVITIES Grades Participated
9 10 11 12
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Awards/Leadership Positions/Comments:
EMPLOYMENT Dates
of Employment
From To Comments
|
|
|
|
|
|
|
|
|
|
III. ADMINISTRATOR RECOMMENDATION
The member school principal or designee must submit a
letter of recommendation for the student-athlete who is applying for the
IHSSDOF/INSKEEP Scholarship. Please address
the student’s character, sportsmanship, citizenship, leadership, and work ethic
giving as concrete examples when possible.
This recommendation must be no longer than two pages in length, and no
less than a Times Roman 12 point font.
IV. COACH RECOMMENDATION
The coach must submit a letter of recommendation for the
student-athlete who is applying for the IHSSDHOF/INSKEEP Scholarship. Please address the student’s character,
sportsmanship, citizenship, leadership, and work ethic giving as concrete examples
when possible. This recommendation must
be no longer than two pages in length, and no less than a Times Roman 12 point font.
IHSSDHOF / INSKEEP SCHOLARSHIP
APPLICATION FORM
V.
Applicants must answer the following questions in the space
provided:
A. Why is sportsmanship important in interschool athletics?
B.
How has athletic participation contributed to your development as a
productive
member
of society?
C.
Briefly discuss a challenge
that you as an athlete or as a person have had to overcome
and how your
participation in athletics helped you overcome this challenge?
The deadline for
member schools to submit applications to the Hall of Fame Scholarship Chairperson
is
March 31, 2012.
The mailing address for the HOF Scholarship Chairperson
is:
Bev
Arnold
P. Box
808