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
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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.
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
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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
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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: ________________________________________
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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 ______________________________
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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
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