Student Profile

Student's Name:


DOB:


Parents' Name(s)


Street Address:


City:


State:


Zip:


Home Phone:


Email Address:



College Information

List the colleges to which you have applied:


List any colleges where you have been accepted:


Have you received any other scholarships?


If you received any other scholarships, please list them:


Describe your means of college financial support:



Extracurricular Activities

List school related extra-curricular activities. Please provide details.


How many years did you participate in the CYFA program?


List the years that you participated in CYFA:


List academic and athletic awards:


List hobbies and interests:



Additional Information

Provide additional information, facts, or extenuating circumstances that may assist the Selection Committee during the evaluation process:



Scholarship Statement

Why is the CYFA scholarship important to you?



References

Please list at least 3 references