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2012 SUMMER SCHOOL SCHOLARSHIP APPLICATION
PART 1: PERSONAL DATA Complete all items as requested. Print answers neatly below.
Applicant Name:____________________
Current Mailing Address:________________
Email Address:____________________
Telephone Number:____________________
Student Identification Number:___________
Name of Parent or Guardian:____________
Name of High School:__________________
List of summer school course(s) needed:
(Attach copy of unofficial transcript from high school)
________________________________
Student Signature: ____________________
Parent Signature: ____________________
(Needed if under 18 years old)
PART II: PERSONAL STATEMENT
No more than one typed, single-spaced page of information. Be complete in your response to the following
questions.
Explain why you feel you would make a good recipient for the APRI Summer School Scholarship?
Why should the scholarship review committee select you for this award?
Identify any unique accomplishments and challenges you have faced.
How will attending summer school help you to graduate with your peers?
PART III: This part should be completed by a Teacher, Counselor, Career Center
Coordinator, Career & Technical Education Teacher, Advisor, or Administrator of the student’s choice. Please respond
in the space provided below and sign the bottom of the sheet.
Why do you believe this student should be selected for this award?
Are there unique factors or special circumstances that make this student especially worthy of being selected
for this award?
Additional Comments:
Signature___________________________________
Title____________________________
Phone:__________________________________
E-Mail__________________________
Thank you for your support of this student.
Best Regards from the Directors of the APRI Summer School Scholarship Program Committee. Applications must
be received by the APRI Office by 5:00 p.m. May 21, 2012
A. Phillip Randolph Institute - Tacoma Washington Chapter
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