Clear Creek Amana Athletic Booster Club 2017 Athletic/Academic Scholarship Application & Guidelines Applications are due to the guidance counselor s office by March 30, 2017 The Clear Creek Amana Athletic Booster Club is pleased to offer this scholarship program established to encourage good sportsmanship, athletic participation, and academic awareness. Up to 10 senior scholarships for $500.00 each will be awarded to 5 females and 5 males from the Clear Creek Amana High School (CCAHS). The scholarships will be awarded to the individuals who most clearly demonstrate strength in the areas of leadership, sportsmanship, dedication to sport and team, CCAHS academics and service to the community. Qualifications: Applicants must be a student in good standing at CCAHS as well as in good standing with the CCAHS Athletic Programs. Enrollment in a trade school, community college, 2-year or 4-year college will qualify. The student s family must be an active member of the CCA Athletic Booster Club with paid yearly dues. Any Interested senior meeting the above stated qualifications may apply by completing the attached 3 page application form and returning it to the guidance counselor s office no later than Monday, March 30, 2017. Applications may be downloaded from the CCA Booster Club website at www.ccaboosterclub.com or picked up from the school s guidance counselor. A scholarship selection committee will review the applications and select the winners and winners will be annonced at senior awards night. Scholarship payment will be made to the institution of the student s choice after evidence of enrollment is presented to the Booster Club in the fall after high school graduation. Questions can be sent to ccaboosters@gmail.com
Clear Creek Amana Athletic Booster Club 2017 Athletic/Academic Scholarship Application & Guidelines Applications are due to the guidance counselor s office by March 30, 2017 Student First Name Student Last Name Student Mailing Address Student Email address Student Phone Number Student Cumulative G.P.A. Years of CCA Booster Club Membership? (Check grades): 9 10 11 12 What vocational school, community college, college or university are you considering attending? 1. OR 2. Name of Parent/Guardian Parent/Guardian mailing adddress Parent/Guardian email address Parent/Guardian phone number Please List high school sport activities and years participated in: Sport(s) Yrs Participated Yrs Lettered
CCA Booster Club Scholarship Application List Academic & Athletic Awards or Honors Received: (i.e. All Conference, All-State, Honor Roll, National Honor Society, specified other) Community Leadership,School, Activities & Clubs Experience: Participation in activities outside of athletics. Activities may include school related clubs and organizations, community and church related clubs and organizations, community service projects and employment. Organization/Club Positions Held School Years/Work Years Page 3
CCA Booster Club Scholarship Application How has participation in sports prepared you for the future? (Please write a 200 or more word essay) Student Statement: I have read the requirements pertaining to the Booster Club Scholarship Program and completed all necessary forms. If awarded a scholarship grant and change my enrollment at designated institution, I will inform the Booster Club about the change of plans in order for: 1) the scholarship payment to be awarded to my new accredited institution or 2) the scholarship to be withdrawn due to non-enrollment in accredited institution. I certify to the best of my ability that the information here is complete and accurate and that any falsification of information here will result in my being declared ineligible. Signature of Applicant Date of Application Page 4
CCA ATHLETIC BOOSTER CLUB 2017 SCHOLARSHIP Congratulations, you have been awarded a scholarship from the Clear Creek Amana Athletic Booster Club. To redeem your scholarship, your college registrar must complete the following: College, School or University Name Address City State Zip Registrar s Name (Printed) Registrar s Name (Signed) Phone E-mail Official Stamp of College Student s Name Student University ID Number Student Address City State Zip Incomplete information may delay payment. The scholarship money will be mailed directly to the school and comes off your tuition bill. Once this form is received by CCA Athletic Booster Club, the scholarship money will be distributed. Please return the completed form with an official copy of your proof of enrollment after September 1, 2017 to: CCA Athletic Booster Club PO Box 182 Tiffin, IA 52340 If the scholarship is not redeemed by May 1, 2018 the scholarship will be forfeited and will revert back to the CCA Athletic Booster Club. Any questions, please email ccaboosters@gmail.com