This form is to be completed by the student at the end of each year in grades 9-12.

Students should complete all of the items on the check list and give this form to their counselor for verification.

Tennessee Scholars Checklist 2013

Name ____________ School _____________________County______________ Email ___________________Telephone number_________________________
Subject
English 9 English 10 English 11 English 12

Avera ge

Subject
9th grade math 10th grade math 11th Grade Math Higher Math

Avera ge

Subject
Biology Chemistry List 3rd Science Choose only two from the following:

Avera ge

*Name of Class

* You cannot count these courses in more than one category

Bridge Math does not count for TN Scholars Students must take a minimum of Alg. 1 and Alg. 2,geometry and a higher math 1st Social Studies 2nd Social Studies 3rd Social Studies Personal Finance Requirem Language 1 Language 2

CTE class 1 CTE Class 2 Dual Credit class 1 *

Dual Credit class 2

Online class1 Online class 2 AP Class 1 AP Class 2 Other

Fine Arts

Wellness or PE

ent Days Absent

The total days absent cannot exceed 36 for 4 years Final grade Average on a scale of 1 to 5

9th____

requiremen t 10th_______

11th _____

12th _____

ACT Score

Complete the following for Volunteer Service. Each Activity must have a signature to verify your participation in the activity. Go online to see what is acceptable and not acceptable for volunteer service. Name of Activity Date of Activity Number of Hours Signature and phone number of Contact Person

Total of all hours( )