GREATER KANSAS CITY FOOTBALL COACHES ASSOCIATION
FORM DUE NO LATER THAN JANUARY 20th
2021 Scholar/Athlete Nomination Form
Name: ________________________________________________________________
Last First Middle
Permanent Address: __________________________________________ ____________
Street County
___________________________ ____________ ____________
City State Zip Code
Present Telephone: ________ _________________
Area Code Phone number
Name of Father/Guardian: ___________________________________
Place of Employment: _______________________________________
Name of Mother/Guardian: ___________________________________
Place of Employment: _______________________________________
Address of Parents/Guardians (if different from above):
_____________________________________________ _____________________________ _____________ ____________________
Street City State Zip
How many brothers and/or sisters do you have that reside with you?: _______
How many brothers and/or sisters will be attending college next year?: _______
EDUCATIONAL EXPERIENCE:
Name of High School: ____________________________ Graduation Date: ________
ACT Score: _______ SAT Score: _______ Class Rank: _______ 7th Sem. GPA: ______
Approximate number of students in Senior Class: ________________
PLEASE INCLUDE CURRENT TRANSCRIPT WITH APPLICATION
FOOTBALL EXPERIENCE:
Number of Varsity football letters awarded: __________________
List any awards received from your school:
Sophomore: _________________________________________
Junior: _____________________________________________
Senior: _____________________________________________
List any LEAGUE recognition:
Sophomore: _________________________________________
Junior: _____________________________________________
Senior: _____________________________________________
List any KANSAS CITY area awards received:
Sophomore: _________________________________________
Junior: _____________________________________________
Senior: _____________________________________________
List any other football-related awards you have received
Do you plan to attend college: _____________
Do you plan to continue playing football: _________________
If YES, please list your top three choices:
1. ________________ 2. ___________ 3. ___________
If YES, have you received a scholarship offer:
FULL: ______________ PARTIAL: _________________
Please explain below if partial;
Do you intend to WALK-ON: ____________________________________
SCHOOL ACTIVITIES:
List any other extra curricular activities you have participated in during high school, plus the level of participation (what level did you letter in)
Sophomore:____________________________________________________
Junior:_______________________________________________________
Senior:_______________________________________________________
List any honors received in any other sports activity:
Sophomore:____________________________________________________
Junior:_______________________________________________________
Senior:_______________________________________________________
List all activities in which you were selected as a captain:
_____________________ ______________________ _______________________
Briefly describe your future plans for any of these activities:
List any and all academic awards:
List any and all organizations that you have participated in and include any office held:
NON-SCHOOL RELATED ACTIVITIES:
Honor and Awards (i.e., Eagle Scout, etc.). State the nature of the award:
List any other organizations that you belong to (church etc):
Have you been granted any scholarship aide: ______________ If YES please describe:
PLEASE INCLUDE THE FOLLOWING:
1. A letter from the school’s Head Football Coach briefly describing the applicant’s contributions to his high school in the following areas: Scholarship, Citizenship, and Athletics.
2. A letter from the school’s principal briefly accounting for the applicants contributions to his high school in the following areas: Scholarship, Citizenship, and Athletics.
3. A letter from the applicant explaining his goal after graduation.
4. A copy of the applicants 7th semester transcript.
5. All paperwork filled out completely and returned in order.
PLEASE READ AND SIGN THIS FORM:
I/We have reviewed this application and verify to the validity of this information.
Principal: ___________________________________ Date _______________
Head Football Coach _________________________ Date _______________
Return form by January 20, 2021 to:
Grain Valley High School
c/o David Allie, GKCFCA President
551 SW Eagles Parkway
Grain Valley, MO 64029
If you have any questions, please email mhzegunis@
Thanks for supporting the GKCFCA!
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