State PAGE STAR Student Application

Please complete this STAR Student Application and submit by April 20. (You will probably want to construct some your answers separately before beginning this form, then copy and paste the text.)

Region STAR Student Information
STAR Student's Name:*
First Middle Last
Nickname: (Preferred name)
STAR Student's Mailing Address:*
STAR awards will be mailed to the address provided here.

Street Address Address Line 2 City State ZIP Code
STAR Student's Email:*
Enter Email Confirm Email
STAR Student's Phone Number:*
School Information
STAR Region #:*
School System:*
School Name:*
Colleges
Colleges applied to*
Please list all the colleges to which you have applied. Place an asterisk next to the ones to which you have been accepted. For example, "Emory, Georgia Tech*, MIT*, Georgia Southern."
College you plan to attend*
If you haven't yet decided, list your preferred college(s), prefaced by "Not yet decided:"
Activities and Honors
Activities*
List up to three school activities/leadership positions which have meant the most to you in your high school career and tell why they have been important to you.
School Activities 1
School Activities 2
School Activities 3
Honors/Distinctions*
List any honors, awards, or distinctions you have received in grades 9–12.
College Scholarships/Recognitions*
List any scholarships or recognitions you have received from colleges and universities.
Community Service*
List any community service, volunteer work, and/or religious organizations.
Work Experience
List any jobs you have held during the last three years.*
Use the format Date/Position/Employer. For example, "Jun–Aug 2017, lifeguard, Newnan Elks Lodge." If none, just enter N/A.
Date Position Employer
Tell us about you
Describe yourself*
Describe yourself, focusing on two or three characteristics or facts that you consider most significant and that would be interesting to the dinner audience.
Formative School Experience*
Describe a meaningful school experience which has influenced the development of your personal philosophy, career choice, or educational objective.
Society and You*
What do you see as the most difficult problem facing young people today?
Your STAR Teacher
STAR Teacher Name*
Prefix First Last
Why did you choose your STAR Teacher?*
Social Media Information
Photo: (Headshot - senior picture quality)*
Please upload a photo of you here.
Consent Form:*
Please upload your completed consent form here
Points of Interest*
Two points of interest about yourself that you would like to share. (Please limit to no more than 100 words.)
News Media Information
News media contact information
Please list below the names, fax numbers, and email addresses of news media serving your area that you would like notified of your participation in the State PAGE STAR program. You will have the opportunity to identify a local daily newspaper, a weekly newspaper, a TV station, and a radio station. (None are required.)
TV/Radio/Newspaper Editor/Reporter Email Fax#

State PAGE STAR Student Application

Region STAR Student Information

School Information

Colleges

Activities and Honors

Work Experience

Tell us about you

Your STAR Teacher

Social Media Information

News Media Information