Online Scholarship Application | Chicago Blackhawk Alumni Association

Name *

First

Last

School Year *

Address Line 1 *

City *

Address Line 2 *

State *

Email *

Date of Birth (MM/DD/YYYY) *

Home Phone Number *

Cell Phone Number *

Mother's Name *

Mother's Occupation *

Father's Name *

Father's Occupation *

# of Siblings *

Please List Names & Ages *

High School *

Address *

School Contact (Student Advisor) *

School Contact Phone *

School Contact Email *

GPA Scale *

HS GPA *

Junior Year GPA *

Senior Year GPA (As of Dec 31) *

Class Rank *

SAT Scores *

ACT Score *

Hockey Coach Email *

Hockey Coach Phone *

Team Manager Email *

Team Manager Phone *

Position *

Team(s) Played On (Previous 4 Years) *

Will you apply for financial aid to assist with your college expenses? *

Yes No

Is some sort of financial aid necessary for you and. your family to afford tuition at the college of your choice? *

Yes No

Please describe any community service you do/have done (specify approximate number of hours next to each community service organization).* *

Please describe any extracurricular activities you are involved with (in/out of school, excluding hockey). *

Please list any past or current paying jobs. *

Name of University #1 *

Does this university have a hockey program? *

Yes No

Name of University #2 *

Does this university have a hockey program? *

Yes No

Name of University #3 *

Does this university have a hockey program? *

Yes No

Please list any other universities to which you have applied. *

Signature (type your name) *

Date (MM/DD/YYYY) *

How has your experience playing hockey and your exposure to the sport of hockey assisted in your development as a student and as a person? (400 word max.) *

What other qualifications do you have that you believe make you eligible to be awarded with the Blackhawk Alumni Scholarship? (400 word max.) *

Addendum B: Please upload coaches’ letter of recommendation here. (pdf files ONLY). *

Max file size: 20MB

Addendum C: Please upload additional teacher/mentor letter of recommendation here. (pdf files ONLY). *

Max file size: 20MB

Addendum D: Please upload additional teacher/mentor letter of recommendation here. (pdf files ONLY). *

Max file size: 20MB

Please attach all transcripts or send to:
Attention: CBAA Scholarship Program
P.O. Box 72159
Roselle, Illinois 60172

Addendum E: Please upload current high school transcripts here. (pdf file ONLY). *

Max file size: 20MB

Scholarship Application

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Personal Information:

Family Information:

High School Information:

Hockey Information:

Financial Aid Questions:

Personal/community Involvement:

Universities you have applied to:

Applicant Essays:

Chicago Blackhawk Alumni Association