THE RALEIGH SPORTS CLUB, INC. Student Athlete Scholarship Application Form 2015 Deadline March 1, 2015

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1 The Raleigh Sports Club (RSC) will award four (4), $1,500 Scholarships this year to Student Athletes who are graduating seniors, are affiliated with an Athletic Program in a Wake County High School (Public or Private), have been accepted by a College or University and are NOT receiving an Athletic Scholarship. The Raleigh Sports Club Scholarship Committee requests the assistance of Wake County High School Athletic Directors, Coaches, and Staff to aid us in the selection process via the attached Application Form. We offer each Athletic Director the opportunity to submit two candidates to receive a Scholarship Award. To be considered, the completed Application Form must be received by the Raleigh Sports Club by March 1, Please return to: The Raleigh Sports Club, Scholarship Committee, PO Box 10275, Raleigh, NC Criteria for The Raleigh Sports Club Scholarship Awards: The Scholarship will be awarded to a high school senior who is affiliated with an Athletic Program in their Wake County High School (public or private), and has been accepted to a College or University for either a 2-year associates degree or a 4-year degree program. 1. NCAA Rules do not allow a Student who has been offered an Athletic Scholarship to be eligible for a third-party Scholarship; therefore such student would NOT be eligible for a RSC scholarship. 2. Students related to the immediate family of a current RSC Officer, Board Member, or member of the Scholarship Committee are ineligible for a Scholarship. 3. The Scholarship Recipients will be recognized at the RSC's Annual Banquet, to be held at North Ridge Country Club, 6612 Falls of Neuse Rd., Raleigh, NC, on Wednesday evening, April 8, The Scholarship Recipient and two Parents will be the Guests of the RSC at the Banquet. 4. Each Scholarship award ($1,500) will be for the duration of one Academic School Year or 2 semesters of college. The Recipient must enroll in a qualifying trade school, college or university and submit verification of enrollment to the RSC before January 31, 2016, in order to receive the scholarship. The funds will be used to offset the cost to the school for tuition, fees, or room and board. If these costs are paid by other means, the scholarship funds can be used to purchase the student's books. Funds not distributed to the student during the Academic Year due to lack of attendance, etc., will be refunded to the Raleigh Sports Club Scholarship Fund by the College or University. 5. After the student is enrolled they are to contact the Financial Aid Office of the attending college and secure an external award payment submission form which verifies enrollment. This completed form must be submitted to the RSC before January 31, 2016, in order for the scholarship check to be mailed directly to the college and put in an account for the student. To learn more about The Raleigh Sports Club go to our website Questions may be directed to R. Greg Pierce, and raleighsportsclub@yahoo.com (Page 1 of 3 )

2 (This form to be completed by High School Athletic Department) Student Athlete's Name Name of High School Athletic Director Student's Coach (s) Sport (s) of Participation Student's Address Parent(s) or Guardian Name Phone Best Person to Contact Phone Student Gender Student Resides with College or University Student Plans to attend and Course of Study Will Student Athlete's family provide funding for college? Will Student Athlete rely heavily upon 3 rd party scholarships? Other Scholarships Student has or will receive and amounts School related extra curricular

3 activities Non-School related activities Scholastic Information (GPA, Class standing, etc.) (Page 2 of 3)

4 STAFF EVALUATION: Please comment on these and other outstanding qualities of the Nominee. Use back of form if needed. Qualities That Best Define The Character of the Athlete 1. Self Discipline 2. Confidence 3. Passion 4. Citizenship 5. Scholarship CLASS ATTENDANCE RECORD TEAM ATTENDANCE AND PROMPTNESS EFFORTS ON FIELD: Practice, Sidelines, Game COMMITMENT TO THE TEAM EXTRA EFFORT RESPECT OF TEAMMATES INSPIRES OTHERS ON AND OFF THE FIELD COACH S EVALUATION: Reasons you believe this student athlete should receive this Scholarship. Use back of form if necessary.

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