JACK DILLER EDUCATION AWARD Scholarship Application Form ...

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Student’s Acknowledgement of Eligibility Requirements & Promotional Efforts I certify that the information I have provided the Jack Diller Education Award committee for consideration of a scholarship is true and correct to the best of my ability. I understand that any false statements or misrepresentation of materials used and submitted to determine my eligibility will automatically disqualify me from consideration. I understand that in the event I am awarded a scholarship, I grant the Nashville Predators permission to use my name or photo and likeness for the purpose of promoting this community outreach program and its results. I understand publicity efforts will require my active participation and may include use of any media outlet, including but not limited to radio, television and print. I understand the Nashville Predators maintain all promotional rights. If I am awarded the scholarship, I understand that I must enroll and attend college by the fall semester of the year following receipt of my award letter. After this period, I recognize that I forfeit my right to the scholarship. Date: __________________ ______________________________________________________ Student’s signature Date: __________________ ______________________________________________________ Parent/Guardian’s signature RETURN COMPLETED APPLICATION POSTMARKED OR HAND DELIVERED BY FRIDAY, FEBRUARY 20, 2009. Late or incomplete applications will not be accepted.
JACK DILLER EDUCATION AWARD CHECK LIST □ Completed application form (1 page) □ Signed Eligibility Requirements & Promotional Efforts form (1 page) □ Essay (2-3 pages) □ Two (2) letters of recommendation (at least one from the teacher or coach who nominated you) □ Official transcript Please do not include this page in your submission.
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JACK DILLER EDUCATION AWARD Scholarship Application Form ...

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