Julie Foudy Leadership Foundation

Section 1: Personal Information

Student Name

Address

City

State Please Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Student Date of Birth

Parent/Guardian Email

Parent/Guardian Day Phone

Parent/Guardian Evening Phone

Soccer Team/Club Name

For which Academy are you applying? California New Jersey Chicago

Check if applying for the Foudation's 2012 scholarship program for military daughters

Is any organization sponsoring or assisting you with this application? If so, please identify this organization:

Check if you have previously attended the JFSLA

Check if you have previously been awarded a scholarship to attend the JFSLA

If you have attended the JFSLA on scholarship, which session did you attend?

YearLocation

Please check one to identify the student's ethnicity. This information is optional.

American Indian, Eskimo or Aleut

Asian or Pacific Islander

African-American

Hispanic

Caucasian

Other

Section 2: Personal Statement

New students applying: What does leadership mean to you? Describe a person who you consider to be a leader with strong leadership skills.

Returning students applying: How have you applied the leadership skills you acquired while previously attending the Julie Foudy Sports Leadership Academy?

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Section 3: Statement by Coach, Teacher or Adult Mentor

Explain how the applicant will benefit from a week at the Julie Foudy Sports Leadership Academy.

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Section 4: Financial Information*

Parents/Guardians: Please provide the following information.

Parents/Guardians' Taxable Income 2010 (after deductions and exemptions)

$

Parents/Guardians' Estimated Taxable Income for 2011

$

Parent/Guardians: Using the space provided, please explain why your child is in financial need of a scholarship:

Please include any special circumstances (such as more than one child in college, excessive medical bills) or any other situations that may help the panel understand your financial need (please keep your answers to the space provided):

*NOTE: If awarded this scholarship, you may be asked to submit your most recent tax forms to verify your financial information. All financial information will remain confidential and will be viewed only by our scholarship review panel. This panel could include a sponsor or individual benefactor who funded the scholarship.

Parent/Guardian Signature (Required):

I verify that to the best of my knowledge, I have given an accurate representation of our financial information.

Parent SignatureDate Signed

Incomplete applications will not be considered.

**All scholarships are funded and determined by the Julie Foudy Leadership Foundation.**