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Piner High School Athletics Boosters Award Application-2016/17 School Year September 2016
Award
The Piner High School (PHS) Athletics Boosters offers award(s) to
graduating high school Seniors who demonstrate athletic talent,
participation, and teamwork while participating in Piner High
School athletics.
AVAILABILITY
Funds are available to high school seniors graduating from Piner High School at the end of the current
academic year.
APPLICATION AND DUE DATE
An application may be obtained from the Piner High School college and career center or PHS website
http://www.pinerboosters.com. Completed application, copies of required documentation and
references are to be submitted in one envelope and put in the Piner High School Boosters Box in the
office by 4:00pm on March 1st. When March 1st falls on a weekend, holiday or scheduled school
closure, the application will be due by 4:00pm on the following business day. The application will not
be considered if received after the due date or if any of the required materials are missing. Original
application and reference forms must be received in their original form. Facsimiles will not be
accepted.
QUALIFICATIONS
Applicant must have attended Piner High School for a minimum of two years.
Applicant must have participated in a sport at Piner High School in their senior year.
Applicant must have a cumulative grade point average of 2.5 or better. A copy of the student's
high school transcript is required.
Applicant must provide two letters of reference; one must be from a Coach.
Applicant must complete this “Scholarship Application” which includes an essay.
SELECTION
Recipients are selected by members of the Piner High School Athletics Boosters Award Committee.
The Piner High School Athletics Boosters Award is awarded at Piner High School's Awards Meeting.
Award is paid directly to the recipient by check.
1700 Fulton Rd.
Santa Rosa, CA 95403
www.pinerboosters.com
Piner High School Athletics Boosters Award Application-2016/17 School Year September 2016
AWARD APPLICATION
DUE DATE - MARCH 1 APPLICATION WILL NOT BE CONSIDERED IF RECEIVED AFTER DUE DATE
Section 1:
Last Name
First Name
Middle Initial
Street Name
City/State
Zip Code
Telephone E-mail
Date of Graduation
Section 2:
List the sports you participated in:
SPORT(S) GRADE(S) (circle all applicable)
Frosh / Soph / Jr / Sr
Frosh / Soph / Jr / Sr
Frosh / Soph / Jr / Sr
Frosh / Soph / Jr / Sr
Frosh / Soph / Jr / Sr
Frosh / Soph / Jr / Sr
Frosh / Soph / Jr / Sr
Frosh / Soph / Jr / Sr
Piner High School Athletics Boosters Award Application-2016/17 School Year September 2016
Section 3:
List any School Clubs you participated in:
School Clubs Grade (circle all applicable)
Activities/Duties/Responsibilities
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
Section 4:
Volunteer Work (grades 9-12 only) Include your volunteer work at school, volunteer work in
the community-including churches, non-profit organizations.
Name of Organization Grade (circle all applicable)
Activities
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
F / So / J / SR
Piner High School Athletics Boosters Award Application-2016/17 School Year September 2016
Section 5:
Name of Organization Activities
Section 6:
On a separate page please include an essay in 250 words or less, typed, and double spaced
describing what playing sports at Piner High School has meant to you.
Remember to attach two letters of reference and a copy of your current transcript.
SIGNATURE of Applicant (required) __________________________________ Date ________________
Do you give permission for your name to be used in a news release concerning this Award? Yes No
Please keep a copy for your records.
Family Volunteer Work – Include volunteer work for Boosters, team or any other school
sponsored organization on the Piner Campus which was performed by any family member.
