Medallion of Excellence Application
To be eligible for a 2018-2019 Medallion of Excellence Award, should be a high-achieving, community-minded, Volusia & Flagler County high school senior in a public or private school with 25 or more students in the 2019 graduating class. All applicants must be approved by their Principal and/or Guidance Counselor. Selected applicants will be invited to attend the 2019 Banquet. Selected Medallion winners will be notified the week of February 25, 2019.
Email address *
APPLICANT'S INFORMATION
If you are selected to receive a Medallion of Excellence, this information will be used by our editorial staff to compile a thumbnail biography about you for publication in a Special Section of The Daytona Beach News-Journal on Sunday, April 7, 2019.
First Name *
Your answer
Last Name *
Your answer
Mailing Address (Street) *
Your answer
City, State *
Your answer
Zip Code *
Your answer
Applicant's Phone Number
Your answer
Parent/Guardian's Phone Number *
Your answer
Parent/Guardian's Email Address *
Your answer
Parent or Guardian's Name (List up to two parents/guardians as their names should appear if published. Include titles such as Dr., Ms., Mrs., or Mr.) *
Your answer
Name(s) of any family member(s) who were previously awarded a Medallion of Excellence
Your answer
ACADEMIC INFORMATION
School *
Principal or Guidance Counselor's Name: *
Your answer
Current GPA (weighted) *
Your answer
Current class ranking: *
Your answer
SAT Score - Verbal *
Your answer
SAT Score - Mathemetics *
Your answer
Other National Test (Write Test Name & Score) If none, say NONE
Your answer
Title of each IB class you expect to have completed by June of 2019: *
Your answer
Title of each AP class you expect to have completed by June of 2019: *
Your answer
Title of each Dual Enrollment class you expect to have completed by June of 2019: *
Your answer
EXTRACURRICULAR ACTIVITIES - SCHOOL RELATED
Clubs, Sports, Music, Arts or Student-Government
Organization or Team (1)
Your answer
Leadership Position(s)
Your answer
Select year(s) that apply
Organization or Team (2)
Your answer
Leadership Position(s)
Your answer
Select year(s) that apply
Organization or Team (3)
Your answer
Leadership Position(s)
Your answer
Select year(s) that apply
EXTRACURRICULAR ACTIVITIES - OUTSIDE OF SCHOOL
Special-Interest Groups or Organizations
Organization or Team (1)
Your answer
Leadership Position(s)
Your answer
Select year(s) that apply
Organization or Team (2)
Your answer
Leadership Position(s)
Your answer
Select year(s) that apply
Organization or Team (3)
Your answer
Leadership Position(s)
Your answer
Select year(s) that apply
WORK EXPERIENCE
Employer Name (1)
Your answer
Position
Your answer
Hours per week
Your answer
Short Description of Duties
Your answer
Employer Name (2)
Your answer
Position
Your answer
Hours per week
Your answer
Short Description of Duties
Your answer
Employer Name (3)
Your answer
Position
Your answer
Hours per week
Your answer
Short Description of Duties
Your answer
COMMUNITY SERVICE
List activities that were important to you and what kind(s) of services you provided.
List up to three volunteer activities and the service(s) you provided:
Your answer
Total Community Service Hours
Your answer
AWARDS, HONORS and/or RECOGNITION'S
Sports, Fairs, Academic, Other
List your three most significant recognition's and list the corresponding year:
Your answer
COLLEGE/UNIVERSITY INFO
College/University you plan to attend/Status
Your answer
Anticipated College Major
Your answer
Career Plans (If known)
Your answer
PERSONAL STATEMENT
Outside of your academic achievements, what do you consider to be your greatest accomplishment? (Limit statement to 500 words) *
Your answer
A copy of your responses will be emailed to the address you provided.
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