Junior Golf Scholarship Application Supported by

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Junior Golf Scholarship Application Supported by Palm Beach County Junior Golf Association Growing Junior Golf for over 45 Years This packet contains information on the PowerBilt Junior Golf Scholarship. Students and parents should read the entire document before filling out the application. Below are a few key reminders: A student must apply on a HB Foundation Scholarship Application provided at the tournament registration or online. Scholarships will be awarded annually based on applicants who qualify. Eligibility: This Scholarship is open to current college bound members who have participated in a minimum of current year tournaments, and who will graduate High School by 2012 during the current season of the application deadline. Return a minimum of 2 counselor / mentor / teacher / instructor type reports. In an effort to recognize local students and to assist them with their higher academic goals, HB Scholarship Foundation has established five (5) $1,000.00 college scholarships to be awarded to five (5) individual high school seniors participating in the Palm Beach County Junior Golf Association. The Deadline for filing is July 15, 2012 PLEASE DIRECT ALL QUESTIONS AND SUBMIT COMPLETED APPLICATION TO: Indian Springs Country Club Attn: Mike McLellan 11501 E. Clair Ranch Rd. Boynton Beach, FL 33437-1445 561-737-5510 Page 1 of 11

I. STUDENT INFORMATION A. Name: (last) (first) (middle initial) B. Social Security number: - - C. Street Address: D. City: E. County: F. State: G. Zip: H. State of legal residence: I. Email Address: J. Telephone: K. Date of Birth: L. Age: M. Citizen of United States: Yes No N. Occupation (if scholarship applicant is working): O. Name of Legal Guardian and their relationship to applicant: P. I will be enrolling as a freshman at: Q. I have not finalized college plans, but will apply/have applied to (in priority order) (1.) (2.) (3.) R. Junior Golf Participation 1. How many years 2. USGA Handicap or average score 3. Junior Tours associated with _ Page 2 of 11

II. EDUCATIONAL INFORMATION A. HIGH SCHOOL INFORMATION (1.) High School Attended (name, address and telephone number): (2.) Cumulative High School Grade Point Average (Must be at least a 3.0 based on a 4.0 scale): (3.) SAT score: /2400 (4.) ACT score: /36 III. PLEASE INCLUDE THE FOLLOWING WITH YOUR APPLICATION: 1. Proof of your SAT Scores 2. Final High School Report Card IV. EDUCATION AWARDS AND RECOGNITION A. Please list any National, State, or County Scholastic Honors received: (National Honor Society, Who's Who, All American Academic Athlete, Etc.) Page 3 of 11

V. EXTRACURRICULAR SCHOOL ACTIVITIES List the appropriate extracurricular high school activities below, including all awards and positions of leadership held by you as well as membership in various student organizations. If additional space is needed, attach a separate sheet. A. Student Government: (list offices held and number of years) B. Extra-Curricular Activities: (list participation in sports, band, and clubs, etc. and number of years) Page 4 of 11

VI. ESSAY QUESTIONS A. Can you think of a single experience in golf that has had the most impact on your growth as an individual? If additional space is needed, attach a separate sheet. B. Why did you choose the college you plan to attend? If additional space is needed, attach a separate sheet. Page 5 of 11

ESSAY QUESTIONS (cont.) C. What core values have you taken from the game of golf and how do you think that this will impact you as you travel through college and then on to your career? If additional space is needed, attach a separate sheet. Page 6 of 11

POWERBILT SCHOLARSHIP APPLICATION INSTRUCTOR/TEACHER REPORT Concerning Scholarship Candidate: Address: City: State: Zip: Excellent Good Average Fair Poor Cooperation Courtesy Dependability Industriousness Initiative Leadership Maturity Sportsmanship Self-Control In your opinion, what kind of scholastic record should this student make at the college level? Excellent Good Average Fair Poor Comments: I do I do not recommend this student be appointed a PowerBilt Scholarship. SIGNED PRINT NAME DATE HIGH SCHOOL: POSITION: Page 7 of 11

POWERBILT SCHOLARSHIP APPLICATION MENTOR REPORT Concerning Scholarship Candidate: Address: City: State: Zip: Excellent Good Average Fair Poor Cooperation Courtesy Dependability Industriousness Initiative Leadership Maturity Sportsmanship Self-Control In your opinion, what kind of scholastic record should this student make at the college level? Excellent Good Average Fair Poor Comments: I do I do not recommend this student be appointed a PowerBilt Scholarship. SIGNED PRINT NAME DATE HIGH SCHOOL: POSITION: Page 8 of 11

POWERBILT SCHOLARSHIP APPLICATION COUNSELOR/REGISTRAR REPORT Concerning Scholarship Candidate: Address: City: State: Zip: Excellent Good Average Fair Poor Cooperation Courtesy Dependability Industriousness Initiative Leadership Maturity Sportsmanship Self-Control In your opinion, what kind of scholastic record should this student make at the college level? Excellent Good Average Fair Poor Comments: I do I do not recommend this student be appointed a PowerBilt Scholarship. SIGNED PRINT NAME DATE HIGH SCHOOL: POSITION: Page 9 of 11

POWERBILT SCHOLARSHIP APPLICATION GOLF COACH/INSTRUCTOR REPORT Concerning Scholarship Candidate: Address: City: State: Zip: Excellent Good Average Fair Poor Cooperation Courtesy Dependability Industriousness Initiative Leadership Maturity Sportsmanship Self-Control In your opinion, what kind of scholastic record should this student make at the college level? Excellent Good Average Fair Poor Comments: I do I do not recommend this student be appointed a PowerBilt Scholarship. SIGNED PRINT NAME DATE HIGH SCHOOL: POSITION: Page 10 of 11

MISSION STATEMENT The HB Foundation's priority is to grow the game of golf while using the game to enhance the quality of life. Working directly with local Junior Golf programs the HB Foundation can assist in golf programs that teach core values such as honesty, integrity, respect, self-assurance, courtesy, sportsmanship and perseverance. Through this scholarship program, the HB Foundation will assist eligible junior golfers with their higher education costs. In an effort to recognize students that have gone through a local junior golf program, college scholarships will be awarded to Junior golfers based on their playing ability, academics, citizenship (community activities), and extracurricular activities (additional school activities) Page 11 of 11