Name :
Address :
City :
State :
Zip :
Phone :
Social Security Number :
Birthdate :
E-Mail :
Grade Point Average :
out of
High School :
Class Rank :
College Entering in Fall 2008 :
Intended college major :
Be sure to include dates and positions held (if applicable)
1. List any honors, awards, or scholarships.
2. List all extracurricular activites and positions held in school-sponsored activities.
3. List any community involvement (sports, clubs, societies, religious, etc.) including community service projects.
4. List any work experience.
5. In 150 words or less, elaborate on a memorable leadership experience you have had.
6. In 150 words or less, explain an academic accomplishment and describe your strongest attribute for academic success in college.
7. In 150 words or less, describe how you are personally committed to living a life of excellence.
8. Where did you hear about the Committed to Lives of Excellence Scholarship?
Please mail an official high school transcript to 10000 Allisonville Road, Fishers, IN 46038 or fax to 317-284-0214.