Nomination Form

Instructions

Entries Due: January 31

Winners will receive a $1,000 scholarship award. Rating based on the following criteria:

Outstanding Academic Achievement (3.0 GPA or better recommended) (40%)
Outstanding football ability, performance, and attitude (40%)
(Minimum 1st team all-region required for nomination.)
Outstanding in campus leadership, excellent citizenship, and community service (20%)

NOTE: Please provide detailed responses. Details help us select the best candidates.

Download this registration form.

Complete Form

Student Name: *

Address: *

City/Town: *

Zipcode: *

Phone Number: *

Parent(s) Names: *

Team Position(s): *

Age: *

Height: *

Weight: *

Name of School: *

School Address: *

City/Town: *

Zipcode: *

School Phone Number: *

Overall Grade Point Average: *

Current GPA: *

ACT Score: *

Student/Athlete Email Address: *

Parent Email Address: *

Football Accomplishments, Honors, and Appraisal (Include individual statistics, if available): *

Scholastic Honors (Honor Roll, National Honor Society, AP classes taken and passed, Honors classes taken, etc.): *

Extracurricular Activities & Citizenship in and out of school (Student leadership, Community service, Musical talents, Club involvement, Hobbies, etc. PLEASE BE COMPREHENSIVE): *

Head Coach Contact Information:

Name: *

Email Address: *

School Principal's Contact Information:

Name: *

Email Address: *

( * Required Field )

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