APPLICATION FOR
JACKIE BURK MEMORIAL AWARD AND
ALLAN HOMES AWARD
FOR OUTSTANDING STUDENT VOLUNTEER FOR
SPECIAL OLYMPICS HOWARD COUNTY
(Please type or
print.)
NAME_________________________________________________________
ADDRESS
_____________________________________________________
CITY
______________________________ STATE
_______ ZIP_________
PHONE NRS
(HOME)___________________ (CELL)__________________
FATHER’S
NAME_______________________________________________
ADDRESS (if
different than student) ____________________________________
CITY_______________________________STATE_________ZIP
_________
MOTHER’S
NAME_______________________________________________
ADDRESS (if
different than student) ____________________________________
CITY_______________________________STATE_________ZIP
_________
HIGH SCHOOL
__________________________________________________
DATE OF GRADUATION
______________________GPA _______________
POST-HIGH SCHOOL
EDUCATION PLANS: (include technical schools/colleges, etc. applied to/accepted to; major):
IF CURRENTLY IN
COLLEGE:
COLLEGE
____________________________________________________________
ANTICIPATED
GRADUATION YEAR ___________________________________
MAJOR
__________________________________
SUMMARIZE INVOLVEMENT
WITH SOHO (include sports/events that you have volunteered with, number of
hours and years of involvement. Be specific.)
DESCRIBE (500 words
or less) WHAT YOUR INVOLVEMENT IN SOHO HAS MEANT TO YOU AND WHAT IMPACT IT HAS
HAD ON YOUR LIFE.