Illinois Directors of Student Activities Scholarship Application
Application Requirements

Two $1,000 scholarships will be awarded based upon the following:
- Application:
1. Involvement within and outside of your school
2. Responses to two of three essay questions
- Two teacher/advisor recommendations.

Deadline: February 1, 2020

If you have an questions with regards to the scholarship submission process, please contact:
Dr. Deborah Beagle
IDSA Exec Board
deborah.beagle@d128.org
Applicant's First Name *
Your answer
Applicant's Last Name *
Your answer
Applicant's Home Address
Your answer
Applicant's Phone #
Your answer
Applicant's Email Address *
Your answer
High School *
Your answer
High School Phone # *
Your answer
High School Principal's Email *
Your answer
Activity Involvement within Your School
List the top five activities in which you have participated at your high school. Include school clubs, teams, musical groups, leadership groups, and any other activities or organizations. Please check the appropriate box for each year of your involvement. Write a brief description of your leadership responsibilities or participation in the activity.
Activity #1
Ex: Student Council, Speech Team
Your answer
Years of Participation in Activity #1
Roles within Activity #1
Ex: Secretary, Food Drive Committee Chairperson, Team Captain, Newspaper Editor, Snowball Leader
Your answer
Coach/Advisor Email for Activity #1
This email address may be used for verification of this activity.
Your answer
Activity #2
Your answer
Years of Participation in Activity #2
Roles within Activity #2
Your answer
Coach/Advisor Email for Activity #2
This email address may be used for verification of this activity.
Your answer
Activity #3
Your answer
Years of Participation Activity #3
Roles within Activity #3
Your answer
Coach/Advisor Email for Activity #3
This email address may be used for verification of this activity.
Your answer
Activity #4
Your answer
Years of Participation Activity #4
Roles within Activity #4
Your answer
Coach/Advisor Email for Activity #4
This email address may be used for verification of this activity.
Your answer
Activity #5
Your answer
Years of Participation Activity #5
Roles within Activity #5
Your answer
Coach/Advisor Email for Activity #5
This email address may be used for verification of this activity.
Your answer
Activity Involvement outside of Your School
List the top two activities in which you have participated that are not associated with your high school. This may include youth groups, scouting groups, volunteer organizations, church groups, etc.. Write a brief description of your leadership position or participation in the activity. Please do not include paid jobs.
Community Service #1
Ex: PADS Soup Kitchen
Your answer
Total Hours for Community Service #1
Your answer
Community Service #1 - Services Performed
Your answer
Email Contact for Community Service #1
This email address may be used for verification of this service.
Your answer
Community Service #2
Your answer
Total Hours for Community Service #2
Your answer
Community Service #2 - Services Performed
Your answer
Email Contact for Community Service #2
This email address may be used for verification of this service.
Your answer
Essay Questions
Select two of the three questions. Limit your response to 250 words or less. Please do not answer all three questions.
Essay Option 1
What do you feel will be the legacy you are leaving at your high school upon graduation? In other words, how have you made your school a better place?
Your answer
Essay Option 2
How has involvement in activities improved your high school experience?
Your answer
Essay Option 3
What skills have you gained through your involvement in activities that will benefit you in your college career?
Your answer
Teacher or Advisor Recommendations
Two teacher/advisor recommendations are required. The teacher/advisor recommendation form will be sent to the email addresses of the names that you provide below.
Teacher/Advisor Recommendation #1 *
Please enter the email address for the teacher or advisor to whom you would like IDSA to send the recommendation form.
Your answer
Teacher/Advisor Recommendation #2 *
Please enter the email address for the teacher or advisor to whom you would like IDSA to send the recommendation form.
Your answer
Application Submission
Electronic Signature *
By selecting the signature option below, I confirm all information I provided truly indicates activities in which I was involved.
Submit
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