Detroit Athletic Club 2009 Michigan High School Athlete of the Year

Detroit Athletic Club2009 Michigan High School Athlete of the YearNominee Application – Please print or typeStudent Name _____________________________________________________________________________FirstLastHigh School _________________________________________________________ Class: A B C DSchool Address ____________________________________________________________________________________________________________________________________________________________City Zip Phone___________________________________Home Address ______________________________________________________________________________________________________________________ __________________ ___________________________City Zip PhoneEmail Contact __________________________________________ATHLETICS (MHSAA Sanctioned)Check grades when you receivedawardAll State First Team (indicate ranking or place)/Dream Team First TeamIdentify sport, individual competition, event (include times if relevant): 9 10 11 12Other Sports Participated InNational (indicate ranking or place, include times if relevant)International (indicate ranking or place, include times if relevant)Other Athletic Achievements/AwardsThis form may be reproduced to nominate multiple students.(continued on other side)Return application and letter of endorsement by January 31, 2009 to Jane JuszczykDetroit Athletic Club · 241 Madison Ave. · Detroit, Michigan 48226 · 313-442-1014 · janej@thedac.com · 313-963-3155 fax

CITIZENSHIP(Student Government, Community Involvement, Volunteerism, etc. -- note leadership positions)Check grades when youparticipated9 10 11 12SCHOLASTIC ACHIEVEMENTCumulative Grade Point AverageACT: SAT: PSAT:Check grades when youreceived awardScholastic Awards 9 10 11 12College Choices (in order of preference):Attach at least one letter of endorsement from a coach, teacher, counselor, athletic director or principal.I HAVE REVIEWED THIS INFORMATION AND ATTEST TO ITS ACCURACY:Student’s Signature _____________________________ Parent or Guardian’s Signature ___________________________Athletic Director’s Signature _____________________________ Principal’s Signature ___________________________This form may be reproduced to nominate multiple students.Return application and letter of endorsement by January 31, 2009 to Jane JuszczykDetroit Athletic Club · 241 Madison Ave. · Detroit, Michigan 48226 · 313-442-1014 · janej@thedac.com · 313-963-3155 fax