THE



PIKES PEAK JUNIOR GOLF SCHOLARSHIP APPLICATION FORMTHE APPLICATION FOR AND THE ACCEPTANCE OF THIS SCHOLARSHIP IS SUBJECT TO THE STUDENT ATTENDING AND COMPLETING THE CURRENT SCHOOL YEAR. BY SIGNING THIS APPLICATION THE STUDENT AND PARENTS OF THE STUDENT HEREBY ACKNOWLEDGE A FINANCIAL RESPONSIBILITY TO REPAY FUNDS THAT ARE ACCEPTED AND USED FOR EXPENSES, IF THE STUDENT DOES NOT COMPLETE THE SCHOOL YEAR.Student Information (This application must be completed using Microsoft Word)First Name:Last Name:Social Security Number:Birthdate:Street:City:State:Zip:State of Residence:Telephone:Father’s Full Name:Occupation:Mother’s Full Name:Occupation:High School:City:State:Zip:Graduation Date:Class Size:Rank:High School GPA (4.0 scale):SAT Score:ACT Score:College Information (the college you will be attending during the current academic year)College Name:Street:City:State:Zip:Have you been accepted:Please list any other scholarships (athletic or academic), grants, etc. that you are receiving. Enter each scholarship on a separate line.Please write a brief paragraph in the box below about the importance of a college education and indicate the career field that you would like to pursue:Extracurricular ActivitiesAll applicants must complete this section of the scholarship application. Indicate the high school activities in which you participated for at least one half year by circling the appropriate grade level in which participation took place. Please indicate the extracurricular activity from the categories listed below.Student GovernmentStudent PublicationsDrama and SpeechTeam and Individual SportsMusicClubs and OrganizationsClass Level(s)Activity9101112Honors - Awards - Special RecognitionUse the space below to list any honors, awards, or special recognition that you received during high school. Be brief, but give all necessary information.PLEASE USE AN EXTRA SHEET OF PAPER IF YOU NEED MORE SPACEI certify that, to the best of my knowledge, the high school activities, awards, and personal information indicated for this student is accurate and complete.Student’s SignatureDateParent’s SignatureDateHigh School Official SignatureDateSchool NameDateApplication ChecklistPlease check off the items listed below to insure that you have included all required documents and material and that the application is filled out in its entirety.High School transcripts and attendance recordsCopy of most current SAT and ACT scoresA copy of letter of acceptance from college of choiceLetters of recommendation from:A member of the P.G. A. of AmericaHigh School golf coach or counselorComplete the student information sectionComplete the extracurricular activities information sectionComplete the honors and awards sectionAll required signatures must be on the application formMail the application to: Mr. Larry MullisDirector, Pikes Peak Junior Golf1325 Commanchero DriveColorado Springs, CO 80915THE DEADLINE FOR SUBMITTING THIS APPLICATION JULY 1 ................
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