Student Application

Name(Required)

First Last

Student Email(Required)

Student Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email(Required)

Parent/Guardian Phone(Required)

What relationship is this Parent/Guardian to you?(Required)

Please identify how many of the following people live in your home:(Required)

Mother

Father

Guardian

Brothers

Sisters

Grandparents

Aunts

Uncles

Others

1. What is your favorite subject? Why?(Required)

2. How do you spend your spare time?(Required)

3. What person whom you know do you most admire? Why?(Required)

4. What is the most difficult situation you have faced? How did you handle it?(Required)

5. Why do you want to go to college?(Required)

6. What do you want to study in college? Why?(Required)

7. Has anyone in your family ever attended college?(Required)

Yes

If yes, where did he/she attend and did he/she graduate?

8. Have you ever been on a college campus? If yes, where? What did you think of it?(Required)

9. Why are you interested in having a mentor?(Required)

10. What school activities are involved in?(Required)

11. What community service/volunteer activities are you involved in?(Required)

12. What else would you like us to know about you?(Required)

Signature(Required)

Date(Required)

Parent/Guardian Authorization

Your child has been nominated for the Saratoga Sponsor-A-Scholar program, which provides up to a $10,000 sponsorship for college and mentoring beginning in tenth grade through freshmen year in college, and academic support and enrichment activities in the Saratoga Springs School District. If you are interested in having your child considered for this program, please respond to the questions below and return this form to the person who gave it to you. Your annual income must adhere to the free or reduced lunch guidelines.

1. Why do you want the nominee to be in Saratoga Sponsor-A-Scholar?(Required)

2. Are you interested in being involved in parent/guardian meetings about helping your student get to college? Why?(Required)

What is your annual household income?(Required)

How many people does this income support?(Required)

SSAS MENTORING:

SSAS provides volunteer community mentors for each of its scholars. A mentor is an adult who, along with parents, teachers, coaches, counselors and other caring adults, provides an SSAS scholar with support, counsel, friendship and a constructive example. Students are required to meet with mentors at least once a month. Mentors go through a standard background check processed by Commercial Investigations, LLC.

SSAS MENTORING:(Required)

I want my son/daughter to have an SSAS mentor.

I do not want my son/daughter to have an SSAS mentor.

Name of Parent or Guardian(Required)

First Last

Relation to Nominee(Required)

Signature of Parent or Guardian(Required)

Date(Required)

Saratoga Springs High School Sponsor-A-Scholar

As part of the SSAS program, students’ grades are reviewed quarterly by our Board of Directors to review their progress and often times, students’ images are used for brochures and other media sources in order to promote the program. We also have students attend mandatory college visits, cultural events, shows, presentations, etc. throughout the school year.

Consent(Required)

I give consent

I give consent for Saratoga
Springs High School Sponsor-A-Scholar Board Members and
Mentors to review my student's
academic records and the ability to use their image for promotional
purposes (e.g. flyers, fundraising posters, etc.).
I also give permission for my student to attend all college tours, cultural
events, shows, presentations, community service projects, etc. that may be
held during the school day throughout their high school career.

Parent/Guardian Name(Required)

First Last

Parent/Guardian Signature(Required)

Date(Required)

Name

This field is for validation purposes and should be left unchanged.

Parent/Guardian Authorization

SSAS MENTORING:

Saratoga Springs High School Sponsor-A-Scholar

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