BLESSING Health System Recommendation Form Student Name: School: Grade Point Average (on a 4.0 scale): Home Address: Home Phone: Sport: Local Newspaper email or FAX: Brief summary of academic ability and school standing (class ranking, honor society, extra curricular activities, etc): Reason for Athletic Recommendation (stats, all conference, all state, MVP, etc): Sportsmanship/Community Involvement: (attach additional pages if needed) Athletic Director: Principal: Please return forms to: KHQA Student Athlete of the Week Attn: Chris Duerr *Must be in good academic standing 301 $ 36" Street (3.5 on a 4.0 scale preferred) Quincy, IL 62301 *Must be a participant of an IHSA, |AHSAA, or 217.224.4909 MSHSAA recognized sport. : eduerr@khga.com *Multi-sport athletes are eligible to be a Student Athlete one time,