JEANNE ROBERTS FAVARO SCHOLARSHIP

Application Form

PERSONAL
Name:
Address:

Telephone:
High School Attended:
U.S.S. Team Affiliation:

Note to the Scholarship Candidate: Please feel free to provide your responses on a
separate sheet of paper. Responses should be type written and categorized as listed
on this application form. THIS IS YOUR CHANCE TO SELL YOURSELF AND
YOUR ACCOMPLISHMENTS!

The recommendation statements may also be on a separate sheet of paper and

MUST be signed by the author at the bottom of the statement. The candidate must
attach all separate sheets to this application form and MUST sign at the end of this
form.

ACADEMIC ACCOMPLISHMENTS (Include GPA and any awards)

SWIMMING ACCOMPLISHMENTS (Please list achievements and awards)

ACTIVITIES OUTSIDE OF SWIMMING AND ACADEMICS

(Work experience, volunteer activities)

COLLEGE PLANS – Please tell us about your plans for the Fall

U.S.S. OR HIGH SCHOOL COACH’S RECOMMENDATION

Signed: Date: / /
HIGH SCHOOL COUNSELOR/INSTRUCTOR
RECOMMENDATION

Signed: Date: / /

Finally, please compose for us a one page essay (be succinct!). Please tell us about
the values and life lessons you have learned through swimming. Please discuss how
you incorporate these values in your daily life and how to you pass those values on
to those around you. Your essay should be typewritten on a separate sheet of paper
and attached to this application form.

APPLICANT’S SIGNATURE
Signed: Date: / /