ADGFF Scholarship Application

Are you currently a member of a track club?

YesNo

Athlete Information

MaleFemale

Name*

Date of Birth*

Address*

Home Phone

Cell Phone

Email*

Parent/Guardian

Name*

Address*

Home Phone

Cell Phone

Email*

Occupation*

Parent/Guardian 2

Name

Address

Home Phone

Cell Phone

Email

Occupation

Academic Information

High School*

Address*

Phone*

Grade*

Cumulative Academic Average (beginning in grade 9)

Athletic Information

Height (cm)*

Weight (lbs)*

Track Events

Main Event*

Best Performances

1.*


2.


3.

Event 2

Best Performances

1.


2.


3.

Event 3

Best Performances

1.


2.


3.

Best Performances

District Meet

Event #1



Event #2



Event #3

OFSAA Regionals

Event #1



Event #2



Event #3

Provincials/OFSAA

Event #1



Event #2



Event #3

Other Sports Played

Level of Other Sports

Highest Achievement

Athletics Awards

High School Coach

Name*



Phone



Email

References

Reference #1

Name*



Phone*



Email*

Reference #2

Name



Phone



Email

Reference #3

Name



Phone



Email