Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Homeschooled?

Yes

No

High School Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Disclaimer *

The Guilford County Sports Hall of Fame (GCSHOF) and its Board does not claim ownership of the information you provide us or post, upload, input or submit to any GCSHOF web page or its associated services (collectively "Submissions"). However, by posting, uploading, inputting, providing or submitting your application you are granting the GCSHOF and its Board permission to use your Submissions in connection with the operation of their scholarship application process including, without limitation, the rights to: copy, distribute, transmit, publicly display, publicly perform, reproduce, edit, translate and reformat your Submissions; and to publish your name in connection with your Submissions. The GCSHOF is under no obligation to post or use any Submissions you may provide and may withdraw your application from consideration for the scholarship at any time, especially if (1) submission occurs past the stated deadline, (2) information presented to the Board in which the applicant's behavior or status with the GCSHOF would negatively affect their relationship to the GCSHOF or its community, or (3) if the applicant is convicted of any crime during the application and awarding process up to their college entry start date. By posting, uploading, inputting, providing or submitting your Submissions you warrant and represent that you own or otherwise control all of the rights to your Submissions as described in this section including, without limitation, all the rights necessary for you to provide, post, upload, input or submit the Submissions. *Please understand that your application file is NOT complete until a non-parent/guardian representative of your designation - Teacher, Coach, Minister, mentor, etc.) sends us a letter of recommendation on your behalf. This can be in email form or an attached document and may be sent to: GCSHOFscholarshipinfo@gmail.com Please acknowledge that you understand all of the points above:

I agree and wish to submit my application

Digital Signature *

I hereby certify that, to the best of my knowledge, the provided information is true and accurate. Digital signature of the applicant:

First Name

Last Name