CHANTILLY HIGH SCHOOL
ATHLETIC BOOSTERS SCHOLARSHIP
2014-2015
The Chantilly Athletic Boosters is pleased to be awarding 4 Scholarships in 3 different
categories this year, for a total of 12 scholarships. We encourage all students who feel they
exhibit the following qualities to apply. The categories are as follows:
Scholar Athlete Award: 2 male and 2 female
This scholarship will be awarded to the students who exhibit leadership and success in both
the athletic and academic setting.
Athletic Leadership Award: 2 male and 2 female
This scholarship will be awarded to the students who excel in the athletic setting while
earning the respect of coaches for their leadership qualities.
Champion of Character Award: 2 male and 2 female
This scholarship will be awarded to the students who have contributed to their team, while
maintaining and enriching their character thus serving as a role model for others.
Page 1 of 4
Form: CHS Athletic Boosters Scholarship Application
Last Updated: February 2015
CHANTILLY HIGH SCHOOL
ATHLETIC BOOSTERS SCHOLARSHIP
2014-2015
All applicants must complete all of the following to be considered. Completed applications,
including recommendation forms, must be submitted to the Career Center no later
than Thursday, April 16, 2015
Applicant’s Name: __________________________________________________________
Applicant’s
Number:
Address: ___________________________________________________________________
____________________________________________________________________________
____________
Home Phone: _______________________________________________________________
(Please use the
last 5 digits of
your Student
ID number.)
Application Criteria:
1. Parents/Guardian must be Chantilly Athletic Booster members as of December 31,
2014.
2. Applicant must be a senior and involved in at least one varsity sport as a player,
manager, or student athletic trainer for a minimum of one full season.
3. Applicant must not be receiving a full scholarship from a 4-year college or university.
4. Application must be accompanied by a copy of the high school transcript with 7th
semester grades included. (Unofficial transcript is acceptable.)
5. Application must be accompanied by a Coach’s completed Recommendation Form.
The coach should use the Applicant # (not the applicant’s name) when completing the
form. Completed recommendation should be submitted to Mrs. Acosta or Mrs.
Robertson in the Career Center by the coach no later than Thursday, April 16, 2015.
6. All application materials must be submitted by the applicant him/herself to Mrs.
Acosta or Mrs. Robertson in the Career Center no later than Thursday, April 16,
2015.
I certify that all of the information contained in this application is correct to the best of
my knowledge. I further certify that the required essay is my own original work.
__________________________________
Applicant’s Signature
__________________
Date
Include this cover sheet when turning in the application to the CHS Career Center.
Page 2 of 4
Form: CHS Athletic Boosters Scholarship Application
Last Updated: February 2015
CHANTILLY HIGH SCHOOL
ATHLETIC BOOSTERS SCHOLARSHIP
2014-2015
You must use this form. If you run out of room please continue this format on an
additional page.
Applicant’s Number:
____________________
High School Athletic Participation:
Sport
Grade
Awards / Honors/3.5
Athlete
Grade
Awards / Honors/
Grade
Honors/Positions Held
Other High School Activities:
Community Svc/Work Experience:
Applicant’s Statement:
Attach a typed personal statement no more than one page (double spaced, with 1” margins)
about the following:
Briefly describe your best or your worst day/experience as part of an athletic team at Chantilly
High School. Please explain what this experience meant to you and what you learned from it.
Coach’s Recommendation:
Ask one of your coaches to complete the Coach’s Recommendation Form, and turn it into the
Career Center no later than Thursday, April 16, 2015.
Page 3 of 4
Form: CHS Athletic Boosters Scholarship Application
Last Updated: February 2015
CHANTILLY HIGH SCHOOL
ATHLETIC BOOSTERS SCHOLARSHIP
2014-2015
Coach’s Recommendation Form
Applicant Number: ___________ has applied for a Chantilly Boosters Scholarship. Please
complete this form and return it to the Career Center no later than Thursday, April 16,
2015. When writing your response, please use the Applicant Number listed above, not the
individual’s name. Thank you for your assistance. If you would rather e-mail the
recommendation please send it to Mrs. Acosta (aiacosta@fcps.edu) or Mrs. Robertson
(Alice.Robertson@fcps.edu). If you choose to e-mail the recommendation, please be sure to
include the scale listed below.
How long have you known the applicant? __________In what capacity? _______________
Please describe any unique qualities that make this student especially worthy of receiving
this scholarship. You may want to include leadership and sportsmanship, work ethic,
dependability, team-oriented attitude, integrity, and character strengths. You do not need to
add comments about other activities.
Please rate how highly you recommend this student (5 being your “highest” recommendation)
1
2
3
4
5
Comments: _________________________________________________________
________________________
_________________________
____________
Signature
Sport
Date
Page 4 of 4
Form: CHS Athletic Boosters Scholarship Application
Last Updated: February 2015