Application for the Florida USSSA Girls Fastpitch Scholarship Award

1. Nominee’s Full Name/Address:______________________________________________________
Please Print or Type                             (Last)                                         (First)                 (Middle)
__________________________________________________________________________________
                                                            (Street)
__________________________________________________________________________________
                                                            (City)                                         (State)                 (Zip)

2. Birthdate:_____________________/______/_____________________________
                            (Month)                     (Day)                 (Year)

3. (     ) Female (     ) Male (Check One)

4. Home Telephone:_______________________Cell #: __________________(Include Area Code)

5. USSSA Sport: ______________Fast Pitch
                          

Academic Data

6. High School Attended:_________________________________________________

Grade Point Average:___________________(on a_________________Scale)
SAT Score:___________________ ACT Score:__________________________

Current Year Certified Transcript attached: YES NO (circle one)

Letter of Acceptance from College or University attached: YES NO (circle one)


List current school , civic & community activities:__________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

List any academic honors or scholarships you have received:__________________________________
__________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________________
 

USSSA History Data

7. List your complete USSSA Youth History Profile below:
        Year/Class                       Team Name,                         City & State Main Position Played
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

8. Describe your greatest thrill while competing in the USSSA Fastpitch Program:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

9. Write a 200 to 300 word essay on How the USSSA Fastpitch Program helps to prepare you for your future college life and adulthood. (Please attach essay to this form)

If you know at this time, please state your intended “major” at college:
__________________________________________________________________________________

10. Have you previously applied for the USSSA Scholarship Award? YES       NO (circle one)

11. List in order three life goals: __________________________________________________
                                                __________________________________________________
                                                __________________________________________________

12. I hereby certify that all the information submitted on this form is true and factual to the best of my knowledge. Signed by Nominee:____________________________________________________


Nomination Sponsorship

NOTE: All nominees for the Florida USSSA Girls Fastpitch Scholarship Award must be sponsored by ONE of the following: USSSA Manager/Coach, USSSA Area Director, USSSA State Director.

This Applicant is being sponsored by: ___________________________________________________
Sponsor’s Name (Please Print)

Sponsor’s Title with USSSA:__________________________________________________________

Sponsor’s Mailing Address:___________________________________________________________

__________________________________________________________________________________
(City, State & Zip Code)

Sponsor’s Telephone Numbers
Residence:________________________________________________________ (Include Area Code)
Business: ________________________________________________________ (Include Area Code)

I respectfully nominate this candidate for consideration for Florida USSSA Girls Fastpitch Scholarship Award. Signed:____________________________________________________________________________

IMPORTANT: All applications for the Florida USSSA Girls Fastpitch Scholarship Award must be received at
Florida USSSA Girls Fastpitch office no later than August 15th . Mail to:

Florida USSSA Fastpitch
2526 Acres Court
Kissimmee, FL 34744

ADMINISTRATIVE USE ONLY

Candidate Qualification Verified
By:__________________________________________________________________Date:_________

Sponsor Qualification Verified
By:__________________________________________________________________Date:_________

Candidate Selected: YES NO (circle one)

Notified of Selection/ Non-Selection:___________________________________Date:_____________