OHIO ATHLETIC TRAINERS’ ASSOCIATION
FAMILY SCHOLARSHIP APPLICATION FORM
* required

Name (Last, First):* ,

Email Address:*
Confirm Email:*

OATA membership # (6 digits)

Date Submitted (mm/dd/yyyy):*

Home Address:
Street:
City:
State Zip Code
Home Phone (xxx-xxx-xxxx):

School Enrolled:

Anticipated Graduation date :*

Declared Major or Minor :

Academic Achievements:

GPA * (round to nearest 0.00; e.g., 3.88, 3.54, etc.)

Have you attended more than one college or university? Yes No
If YES, Please list:

Awards and Grants:
Please list awards (scholarships, grants, etc.) that you have received. These awards must have been earned while enrolled in college. Only include tangible awards that have been received (e.g., plaque, money, etc.). Dean's list, Honorary Societies, Greek Awards, certificates, or financial aid from college funding does not count.

School activities:
Extracurricular Commitments
Please list (with dates) all extracurricular activities and commitments with which you are involved. These activities must have occurred while enrolled in college.

Employment or Work-Study:
Please list (with dates)all jobs that you have held while enrolled in college. Please include work-study positions.

Service Commitments:
Leadership :
Please list (with dates) any leadership positions and roles you have held while enrolled in college (e.g., club officer, class officer, residence assistant, etc.)

Other Service :
Please list (with dates) all other community service activities in which you have engaged while enrolled in college (e.g., Race for the Cure, Project Open Hand, etc.)

Personal Statement (may type here or include an attachment for this after this entry ):
Briefly explain why you chose to enroll in college and what your post-baccalaureate career goals are. Also include a rationale for why you deserve and/or need this scholarship. Please limit your response to the space provided below.

Attachment of Candidate's personal statement :
Who is your parental ATC?
List your 2 references: **
**Direct your references to the Scholarship Letters of Recommendation Link to supply these.

Type the text from this image:

Use alphanumeric digits only.