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ENTRY FORM

Please fill out the following personal information and email this form along
with other suggested entry materials to: AnciraAllStars@kens5.com
Minimum information required:
Your Name ___________________________________________________________________________
Your Address __________________________________________________________________________
Current School ________________________________________________________________________
College or trade school where scholarship would be used ______________________________________
_____________________________________________________________________________________
I have included a picture of me to accompany my application
Additional information recommended:
I am including an essay (1,000 words maximum) talking about myself and why I should win, including
how the scholarship would be used
I am including a letter of endorsement or recommendation from a teacher, coach or mentor, and my
essay tells how that person made a difference
I am including records of my attendance, grade point average, and a sports/outdoor/the arts or
community-involvement achievement over the last 12 months

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