AMA District 17 Club Council

Scholarship Application

 Eligibility:

The District 17 Club Council Scholarship is designed to recognize a rider embodying principles of good scholarship, sportsmanship, citizenship and participation in District 17 events. The District 17 Board of directors can award a Scholarship based on the recommendation of The Scholarship Committee in the amount of $ 500.00 to one or more riders who meet the following criteria.

Applicants must be a full-time student in an accredited high school with senior standing, or currently enrolled student at an accredited community college, college or university, or Vocational/technical School. Applicants must be a District 17 member and ride in one or more District 17 events during the year in which the application is filed.

The Scholarship Committee will consider grades, participation in extracurricular activities, participation in community activities, and participation in District 17 events. The following application and essay must be completed to be eligible for consideration for the District 17 Club Council Scholarship.


Essay


Pick one of the following subjects and submit a minimum of one typed page (500 words) essay (single space, 14-point Arial font) with the completed application.


        What being a member of District 17 means to me.

        What being a member of AMA/ATVA means to me.

        How being a motorcycle / ATV rider has affected my life.

        How I see my future in sport.

Application must be received no latter then September 15 of the current year.


Mail to:                                             Email to:

George Barrington                                  georgejpc@att.net

410 S. Michigan Ave.

Villa Park , IL 60181

Date ____/____/____

Applicant Name ____________________________________ Date of Birth ___/___/___

Address __________________________________ Phone Number (_____) ____-______

City ________________________________________ State __________ ZIP_________

Parent Name ______________________________

Address __________________________________ Phone Number (_____) ____-______

City ________________________________________ State __________ ZIP_________

Currently enrolled in: (Check one and complete the required information)

   High School

   Community College

   College or University

   Vocational/Technical School

Name __________________________________________________________________

Address __________________________________ Phone Number (_____) ____-______

City ________________________________________ State __________ ZIP _________

Grade Point Average ______ Scale ______ Class Rank _______

Month / Year of Graduation ____/____

Extracurricular/ Community Activities ________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

If currently attending high school what school will you be attending next:

Name of School __________________________________________________________

Address ________________________________________________________________

City ______________________________________________ State ______ ZIP _______

Major Field of study _______________________________ Minor __________________

Career Goal _____________________________________________________________

Month and Year classes start _____/_____

If you have graduated high school

Major Field of study ________________________________ Minor _________________

Career Goal _____________________________________________________________

District 17 Member

   No

   Yes AMA Number __________ Number of years a District 17 Member ___________________

Last District 17 event you rode:

Date ___/___/___ Type of event _______________________________________

Location __________________________________________________________