2018-19 BIG 56 Conference Scholar/Athlete Nomination Form
The BIG 56 Conference will provide a total of $2,000 in scholarships to male and female student athletes in recognition for their athletic and academic contributions to their school and communities. The nominee should complete this application in conjunction with the nominating school sponsor. The application criteria involve three main areas including: athletic, academic and extracurricular/community achievements. The awards will be announced at the Spring Baseball and Softball banquet.

Please check off each item from the list below that is included with your form:

Checklist:
Cover Page
Form A – Athletic Participation
Form B – Academic Achievements
Form C – Community Accomplishments
Personal Statement
School Official Statement
School Transcripts
Additional Testimonial Letter (optional)


It is imperative that all required information is complete and accurate. Entries not meeting the stated requirements will not be considered. Forms can be emailed to Dr. Kevin R. Deitrick at kdeitrick@uscsd.k12.pa.us no later than May 10, 2019.

Nominee Name
Your answer
High School
Your answer
Gender
Home Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Nominator Name
Your answer
School Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Daytime Phone
Your answer
Email
Your answer
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