2006-2007 PVS Scholar Athlete Application

Potomac Valley Swimming
2006-2007 Scholar Athlete Award
Application Form

You may use this form to apply for the 2006-2007 PVS Scholar Athlete Awards. Please read the instructions prior to completing the form. Additional documentation must be sent to complete your application.

Last Name:     First Name:     Age:

Club:     USA-S ID:

E-Mail:     Phone No
(your email and telehone number will only be used to contact you if there are any questions about your application.)

High School:

Grade (last completed):     Cumulative Grade Point Average:

Events (list minimum of five):

  Event 1:            Time:   

  Event 2:            Time:   

  Event 3:            Time:   

  Event 4:            Time:   

  Event 5:            Time:   

Event Standard Average:
(A,AA,AAA,AAAA = 4, B,BB = 3, C = 2)

Coach's Signature:
(Coach's signature required ONLY on the mailed copy of this form)

Guidance Counselor's Signature (f necessary):
(SIGNATURE OF GUIDANCE COUNSELOR IS REQUIRED ONLY IF YOUR SCHOOL DOES NOT ISSUE REPORT CARDS WITH A CALCULATED CUMULATIVE GPA)

Be sure to print this form before you click the "Submit" button below.
A copy with your coach's signature must be sent to complete the application.

     

You must apply no later than August 15, 2007. A copy of this form must be mailed, along with a copy of the final report card, and a printout of your times from the USA-S database.

Any questions about the Scholar Athlete Program can be directed to Dave DiNardo.