Scholarship profile sheet

                                  Scholarship PROFILE  SHEET

Name____________________  Address_____________________________  Phone _________

Parent’s Name_________________________ Address ________________________________

Total Family Members ____ Number living at home ____  Number attending college next year ____

Family Income (Optional MUST check to be considered for NEED based awards!)

 Below $25, 000____    $26,000-$35,000____    $36,000-$50,000 ____$51,000-$75,000____

 Above $76,000 ____

ACADEMIC INFORMATION

Scholar’s Program  Yes___ No___     GPA_____WGPA_____  Class Rank____  ACT ____ SAT____

National Honor Society Member   Yes___  No___

Interscholastic Meet Participant  Yes___  No___

List awards won at Interscholastic Meets.

1. __________________ 2.___________________ 3____________________ 4.__________________

List Awards: _______________________________________________________________________

__________________________________________________________________________________

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LEADERSHIP  INFORMATION

Offices held (Class, Student Council or Clubs and Organizations, HOBY, Girls or Boys State)

9th Grade        1.___________________       2.______________________ 3.______________________

10th Grade      1.___________________       2.______________________ 3.______________________

11th Grade      1.___________________       2.______________________ 3.______________________

12th Grade      1.___________________       2.______________________ 3.______________________

ACTIVITIES

List all activities (Band, Vocal Music, Debate, Athletics, Clubs and Organizations)

9th Grade        1.___________________       2.______________________ 3.______________________

                        4.___________________       5.______________________ 6.______________________

10th Grade      1.___________________       2.______________________ 3.______________________

                        4.___________________       5.______________________ 6.______________________

11th Grade      1.___________________       2.______________________ 3.______________________

                        4.___________________       5.______________________ 6.______________________

12th Grade      1.___________________       2.______________________ 3.______________________

                        4.___________________       5.______________________ 6.______________________

                                    COMMUNITY SERVICE AND ACTIVITIES

List any community services, activities, activities or events you are currently or have been participating in. (Examples-Teen Court, Children’s Museum, Food/Clothing Drives, etc..)

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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What are your future plans after high school? (If college or trade school, list school and major!)

_____________________________________________________________________________________ _____________________________________________________________________________________
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Note—I agree to release this information to Scholarship donors.   Yes ___  No ___