Student Application

Student information

First Name:

Last Name:

Middle Initial:

Address:

Email:

Home Phone:

Mobile Phone:

Sponsoring military family member or guardian, branch of service and dates of service:

Branch of Service:

Dates of Service:


Academic information

Name and address of the school you are currently attending:

Name of college, university or vocational school you will be attending:

Address of college, university or vocational school you will be attending:

Year of enrollment and anticipated graduation year:

Cumulative grade point average or equivalent :

List academic awards and honors:

Upload a copy of your high school transcript indicating recent academic work:

(2MB Limit PDF, TXT or Word Document)


Referrals

High school special recognition:

Upload two letters of recommendation. (PDF/Word) Acceptable references include teachers, advisors, faculty members, employers or community leaders:


(2MB Limit PDF, TXT or Word Document)

Briefly explain your leadership or mentoring qualities through participation in extra-curricular or civic activities in school or your community.

Essay Submission
Upload an essay of at least 200 words on how you were inspired by the lessons learned from one of the 37 Hall of Fame players or the four pillars of Citizenship, Service, Sacrifice, and Legacy to future generations in overcoming adversities and challenges.

(2MB Limit PDF, TXT or Word Document)

If you have questions, please send an email to our student advisor: tbuchholz@actofvaloraward.org
Mailing Address: The Bob Feller Act of Valor Award Foundation, PO Box 110 Port Jefferson Station, NY 11776