Win-Win Program #2 COLLEGE TECH ESSAY CONTEST APPLICATION FORM

Our second Win-Win Program's intent is to provide essential technology supplies for student athletes entering their freshman year of college. To qualify for the College Tech Essay Contest, a candidate must be a college-bound high school senior student athlete who embodies the values of Successful Jocks This essay contest opens in the Spring/Fall of each year. Contestants must complete an application, provide proof of college acceptance, submit a short video essay between 60-90 seconds long introducing themselves and write/submit a one-page essay on a topic: provided by our organization. Prizes for the winners may include, but are not limited to laptops, I-pads, tablets and/or printers. Please note that all applicants must be US Citizens.

APPLICANT'S BIOLOGICAL INFORMATION:

FIRST NAME:

LAST NAME:

DATE OF BIRTH:

ETHNICITY:

GENDER:

APPLICANT'S CONTACT INFORMATION:

Address:

CELL PHONE:

EMAIL ADDRESS:

This address will receive a confirmation email

***Please note that SJ will communicate with you via email about the status of your application

TWITTER NAME:

INSTAGRAM NAME:

SNAPCHAT NAME:

***Please note all applicants must follow @successfuljocks on Twitter and/or Instagram to be considered

ARE YOU FOLLOWING @SUCCESSFULJOCKS ON:

TWITTER INSTAGRAM BOTH

APPLICANT'S HIGH SCHOOL AND COLLEGE INFORMATION:

NAME OF HIGH SCHOOL:

GRADE:

HIGH SCHOOL ATHLETIC EXPERIENCE:

1 YEAR 2-3 YEARS ALL 4 YEARS

TRAVEL SPORTS EXPERIENCE:

NONE 1-3 YEARS 3 OR MORE YEARS

WHAT SPORT(S) DO YOU PLAY?

COACH NAME:

COACH PHONE NUMBER:

COACH EMAIL ADDRESS:

NAME OF COLLEGE ATTENDING:

PARENT(S)/GUARDIAN(S) INFORMATION:

PARENT/GUARDIAN FIRST NAME:

PARENT/GUARDIAN LAST NAME:

PARENT/GUARDIAN EMAIL ADDRESS:

PARENT/GUARDIAN PHONE NUMBER:

UPLOAD SUPPORTING DOCUMENTS:

PLEASE ATTACHED A SHORT VIDEO, BETWEEN 60-90 SECONDS (speak clearly) INTRODUCING YOURSELF, STATING YOUR FIRST AND LAST NAME, HIGH SCHOOL, GRADE, SPORT AND YOUR HOBBIES/CHARITY INVOLVEMENT. Video's can also be texted to: (813) 947-0217

Upload (8MB)

PLEASE ATTACH YOUR COLLEGE ACCEPTANCE LETTER: Letters can also be emailed to: info@successfuljocks.org

Upload (8MB)

PLEASE ATTACH YOUR WRITTEN ONE PAGE ESSAY ON THE TOPIC: “What lessons can you learn from sports that can help you become successful in life?” Essays can also be emailed to: info@successfuljocks.org

Upload (8MB)

OTHER RELEVANT INFORMATION:

HOW DID YOU HEAR ABOUT SUCCESSFUL JOCKS?

HONOR CODE AND SUBMISSION:

Please check this box to verify that all information submitted is complete and truthful to the best of my knowledge:

Yes, this information is truthful and to the best of my knowledge.

Typing your name will serve as your signature.

APPLICANT'S SIGNATURE

DATE

Win-Win Program #2 COLLEGE TECH ESSAY CONTEST APPLICATION FORM

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