Success Beyond the Classroom

2011-12 Scholarship Application/Criteria

Please return your completed application to your school’s athletic director

or mail to: 5575 W. Broad Street
Columbus, OH 43228

2011-12 school year deadlines for SBC applications: (fall) Aug 5, (winter) Nov. 4,
(spring) March 9. Applications turned in to schools must be received by the end of the
school day. Mailed applications must be received (not just postmarked) by the deadline
date. All deadlines are firm. Applications received after the established deadlines will
not be considered for scholarships.

Student Name________________________________________________

School_______________________Sport__________________________

Parent/Guardian’s Name_______________________________________

Street Address_______________________________________________

City, State, Zip_______________________________________________

Phone____________________________ Cell______________________

Father/Guardian Employer_____________________________________
Circle One: Full Time / Part Time

Mother/Guardian Employer_____________________________________
Circle One: Full Time / Part Time

List SWCS activities (grades 7 to 12) in which you participated during the past
twelve months.

______________________________________________________________________

______________________________________________________________________

How does your participation in sports help you to grow as a student? (Attach
additional sheet, if necessary)

______________________________________________________________________

______________________________________________________________________
______________________________________________________________________

Tell us why you deserve a Beyond the Classroom Scholarship? (Attach additional
sheet, if necessary.)

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Scholarship Criteria

Do you qualify for (circle one)?: Free Lunch Reduced Lunch No assistance

Family Size (including parents and guardians): _____________________________

During the last school year, how many students in your family participated in
SWCS extra-curricular activities (include 7th-12th grade)? _______

Please explain any special circumstances that might affect your eligibility for a
Beyond the Classroom Scholarship (include circumstances such as family illness,
extraordinary medical expense, job loss, disability, etc.).
Please provide as much information as possible to help us make an informed
decision.

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Student Signature_______________________________Date_____________

Parent Signature________________________________Date_____________