Long Island Swimming Officials Association Chapter: New York State Certified Swimming Officials Association Serving Sections VIII & XI October 18, 2014 President Frank Dowd Vice President Joseph McCabe Secretary Chris Zimmet Treasurer Barbara Wendt Directors Peter Moeschen Ray Willie Past President Michele Gurrieri Rules Interpreter Robert Kersch Dear Coach: I am proud to announce that the Long Island Swimming Officials Association will, once again, sponsor a Scholar-Athlete Award. The LISOA will be presenting this award to a deserving swimmer or diver who is a senior and has competed for their high school during the 2014-15 season. The high school the individual competes for must be a member of either Section VIII (Nassau) or Section XI (Suffolk). The stipend for the 2014-15 LISOA ScholarAthlete Award will be $1000.00. This award has been given for over a quarter of a century and we are proud that we can be of service to the interscholastic swimming and diving community here on Long Island. Last years recipient was Alexander Belluccia of Hewlett High School. Alexander is currently a freshamn at Ohio State University. It would be appreciated if you would be kind enough to publicize this award to the senior members of your team. In addition, providing them with an application, which is heretofore attached, would be greatly appreciated as well. Should you have several deserving seniors who should be considered, please encourage each and every one of them to apply. All completed applications must be postmarked with accompanying documentation by Monday, January 20, 2015. They should be sent to: Larry Wachter Chairman, LISOA Scholar-Athlete Award Committee 87 Empress Pines Drive Nesconset, NY 11767 Should you, or any of the applicants, have a question, I can be reached at (631) 737-4066 or by email at: [email protected] . On behalf of LISOA Scholarship Committee members Bob Kersch, Walt Gustafson, Ray Willie, Kevin Bishop and myself, thank you for your anticipated cooperation and assistance. Sincerely, Larry Wachter Chairman, Scholar-Athlete Committee Long Island Swimming Officials Association LONG ISLAND SWIMMING OFFICIALS ASSOCIATION 2014 - 2015 SCHOLAR-ATHLETE APPLICATION LONG ISLAND SWIMMING OFFICIALS ASSOCIATION SCHOLAR – ATHLETE APPLICATION (TO BE COMPLETED BY APPLICANT) Application Checklist Completed Application with appropriate signatures Essays Coach’s Letter Teacher/Advisor Letter Transcript Signature of Applicant INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED 1 LONG ISLAND SWIMMING OFFICIALS ASSOCIATION SCHOLAR – ATHLETE APPLICATION (TO BE COMPLETED BY APPLICANT) Date: __________________ Name of Candidate: __________________________________________________________________ Home Address: ______________________________________________________________________ Street Community Zip Code Home Telephone # ___________________ Email Address: _________________________________ Name of High School: ________________________________________________________________ School Address: _____________________________________________________________________ Street Community Zip Code GPA: ______________________________ SAT/ACT: _________________________ List colleges applied to in order of your preference: NAME OF COLLEGE INTENDED MAJOR DATE OF ACCEPTANCE 1. 2. 3. 4. 5. 6. ACADEMIC HONORS Please list all academic honors earned and honor society memberships while in high school. ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ATHLETIC ACCOMPLISHMENTS Please tell us about your top three varsity level swimming events to include your best times, any high school records held and the highest level of high school competition where you have swum these events. Also include any other varsity sports you have participated in while in high school. ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ 2 LONG ISLAND SWIMMING OFFICIALS ASSOCIATION SCHOLAR – ATHLETE APPLICATION EXTRACURRICULAR, PERSONAL AND VOLUNTEER ACTIVITIES (INCLUDING SUMMER) Please list your principal extracurricular, community, and family activities and hobbies in the order of their interest to you. Include specific events and/or major accomplishments such as musical instrument played, varsity letters earned and captain of teams etc. ACTIVITY GRADE LEVEL HOURS PER WEEK WEEKS PER YEAR POSITIONS HELD, HONORS WON OR LETTERS EARNED WORK EXPERIENCE Please list principal jobs you have held during the past three years (including summer employment). HOURS SPECIFIC NATURE OF WORK EMPLOYER DUTIES DATES PER WEEK ESSAYS On separate sheets of paper, please answer the following questions. REMEMBER TO PRINT YOUR NAME AT THE TOP OF EACH SHEET. 1. Please tell us about yourself. Describe your interest. Why do you plan on attending college and any long term goals that you have for yourself. In addition, tell us about any significant occurrences in your life that have made you who you are today. 2. Tell us what you have done to occupy your time over the past two summers. __________________________________ SIGNATURE OF APPLICANT 3 LONG ISLAND SWIMMING OFFICIALS ASSOCIATION SCHOLAR – ATHLETE APPLICATION (THIS SECTION TO BE COMPLETED BY PARENT OR GUARDIAN) Name of Candidate: __________________________________________________________________ Father’s Name: ____________________________ Mother’s Name: __________________________ Occupation: ______________________________ Occupation: ______________________________ Employer: ________________________________ Employer: _______________________________ Address of Employer _______________________ Address of Employer: ______________________ Annual Income: ___________________________ Annual Income: ___________________________ Other members of your household: Name Relationship Age Name Relationship Age 1. ________________________________________ 4.________________________________________ 2. ________________________________________ 5.________________________________________ 3. ________________________________________ 6.________________________________________ Siblings currently attending college: 1. ________________________________________ 3.________________________________________ 2. ________________________________________ 4.________________________________________ Describe any unusual family obligations which may affect your family’s ability to assist the candidate financially: _________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Estimated total cost of first year of college: __________________________ Tuition: ____________________ Room: _________________ Board: _____________________ Books: ______________________ Travel: ________________ Incidentals: ________________ Anticipated financial plan for the first year of college: Candidate savings: _______________________ Family savings: _________________________ Candidate job income: ____________________ Family Income: _________________________ Gifts from friends/relatives: ________________ Loans: _________________________________ Academic scholarship: ____________________ Athletic scholarship: _____________________ SIGNATURE OF PARENT OR GUARDIAN: ________________________________________ 4 LONG ISLAND SWIMMING OFFICIALS ASSOCIATION SCHOLAR – ATHLETE APPLICATION (THIS SECTION TO BE COMPLETED BY SWIM COACH) HIGH SCHOOL SWIM COACH LETTER OF REFERENCE: Name of Candidate: _________________________________________________________________ Tell us about the swimmer you are recommending. Include his abilities as a swimmer and his work ethic with respect to competitive swimming. Share with us any positive influence he may have on his teammates. Describe his personal qualities. Feel free to include any additional comments that you deem significant. Name ______________________________ 5 LONG ISLAND SWIMMING OFFICIALS ASSOCIATION SCHOLAR – ATHLETE APPLICATION SCHOOL ADMINISTRATOR / TEACHER LETTER OF RECOMMENDATION Name of Candidate: _________________________________________________________________ Name of School Official: ________________________ High School: _________________________ Title of School Official: _________________________ Telephone Number: ___________________ On official school letterhead, please tell about the candidate. Tell us about the school activities he is involved in and any leadership roles he has displayed. Any additional comments about any special interests or abilities would also be welcomed. Signature of School Official: ____________________________ A COPY OF AN OFFICIAL SCHOOL TRANSCRIPT MUST ACCOMPANY THIS APPLICATION 6
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