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" T h e   S p i r i t   o f   t h e   S w e e t   S c i e n c e "

American Association for the Improvement of Boxing

86 Fletcher Avenue, Mount Vernon, NY 10552-3319

Tel 914.664.4571   Fax 914.664.3164

h t t p : / / w w w . a a i b . o r g

email: aaib@worldnet.att.net

AAIB Scholarship Request Form

AAIB

HOW TO REQUEST A SCHOLARSHIP FOR A STUDENT

Print out this application, and send it and any other relevant information on the student to:

The American Association for the Improvement of Boxing, Inc.

c/o Scholarship Committee

86 Fletcher Avenue

Mount Vernon, NY 10552-3319

DEADLINE: MAY 1, 2002

For further inquiries, contact the AAIB at (914) 664-4571

SCHOLARSHIP APPLICATION (CUT BELOW)

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

I. PERSONAL DATA:

____________________________________________________________

Last Name

First Name

Date

____________________________________________________________

Address

____________________________________________________________

City

State

Zip Code

____________________________________________________________

Phone (Home)

Email Address

II. CURRENT STATUS:

I am in my senior year at the following High School:

____________________________________________________________

Name of High School

____________________________________________________________

Date of Graduation

III. List of schools to which you have applied:

____________________________________________________________

____________________________________________________________

____________________________________________________________

Have you been accepted?

______

Yes

______

No

If yes, list school, date or acceptance and major below:

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

Name of AAIB Member making recommendation:

IV. The following categories will serve as the criteria in the selection of the most worthy candidate. Please respond to each category carefully. All information will be verified.

A. Scholastic Achievement:

____________________________________________________________

____________________________________________________________

____________________________________________________________

B. Athletic Achievement:

____________________________________________________________

____________________________________________________________

____________________________________________________________

C. Community Involement (Employment or Volunteer):

____________________________________________________________

____________________________________________________________

____________________________________________________________

I hereby certify that the information submitted is true, and I understand that falsification of any information submitted by me to the AAIB, Inc., for scholarship consideration may result in the loss or forfeiture of any scholarship funds.

I authorize ________________________________ (name of school in attendance) to furnish and release perfomrance and financial information to the American Association for the Improvement of Boxing, Inc., pusuant to this application.

Signature of applicant: _________________________________________

Date: ________________