San Francisco State University

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Presidential Scholars Program

Application for 2006-2007

Application (postmarked) Deadline: March 17, 2006

          I. PERSONAL INFORMATION:

_____________________________________________________________________________________________________________________________________________________________________________________________________
Last Name  First Name  Middle Name  Social Security Number    |   DOB

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Present Address:_________________________ Present Phone Number (     )________________
                           _________________________ E-Mail Address:_________________________

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Preferred Mailing Address (if different than above) _______________________________________
Parent/Guardian last name ________________ First name_______________________________
Parent/GuardianAddress (if different than above) _______________________________________

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Career interest or major field of study planned: _______________________________________

      II. PERFORMANCE ON NATIONAL TESTS YOU HAVE TAKEN:

a. American College Test (ACT):
    Composite score_____ English_________ Math___________ Reading_________ Science reasoning_______

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b. Scholastic Aptitude Test (SAT):
    Total score________ Verbal_________ Math___________

SAT II
Subject_________ Score____________
Subject_________ Score____________

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      III. HIGH SCHOOL RECORD* :

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a.  Name of High School Address of High School

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b. Grade point average  weighted______ unweighted_______ Class ranking____of_____
        (4.00 system) (rank)            (class size)

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*Please have your school send your official 7-semester high school transcript to the address at the end of this application

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c.  Extracurricular activities: Please list your extracurricular activities in the order of their importance to you:

(Please attach an additional sheet if necessary)

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Extracurricular activities

 Fr So Jr Sr

Approx. hours/week

Leadership position(s) held:
             
             
             
             
             
             

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d.  Awards: Please list all awards and special recognition you have received in your high school or community:

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Name of Award

 Fr So Jr Sr
         
         
         
         

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e.  Employment: Please identify any work experience you have had:

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Position Employer (or "SE" for self-employed) How long were you employed?
     
     
     

   IV. ADDITIONAL INFORMATION:

Is there any other information you feel pertinent that has not been requested on this application form? If so, please state it in this space: 

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

   V. LETTER OF RECOMMENDATION:

Please ask one of your high school teachers to write a letter about your academic performance
and potential and send it to the address at the end of this form.

   VI. ESSAY:

Please attach a clear, well-organized essay of two pages (500 words), which explains the role which an intellectual or cultural experience (travel, reading a book, seeing a play, hearing a concert, etc.) has had in your life and how it has influenced your personal and professional goals. Tell us how, in turn, San Francisco State University might be able to help you advance these goals. Please type your essay.

The essay provides the selection committee an opportunity to get to know more about you. It also gives you an opportunity to demonstrate your ability to organize your thoughts and express yourself clearly.

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Application and essay, along with letter of recommendation and official 7-semester high school transcript should each be mailed to:

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Academic Program Development

Attn: Presidential Scholars Program, ADM 447

San Francisco State University

1600 Holloway Ave.

San Francisco, CA 94132-4018

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Application (postmarked) deadline: March 17, 2006

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For more information, please visit: http://www.sfsu.edu/~scholars or call us at (415) 338-2789

My signature below indicates that all information in my application is correct and the essay is my own work:

Signature Date

Office: ADM 447 (415)-338-2789  |  Return to Academic Program Development  |  SFSU Home  |  updated by D. Apelt 2/16/06