Economic Development AMP Transmission

Personal Achievement Form

Instructions

Deadline for submission is Feb. 6, 2026.

Points used to determine scholarship recipients will be based on the information provided on this form, so be thorough in providing information. Since this form cannot be saved and completed later, we encourage you to have your answers prepared in advance. It is recommended that you type out your responses in another document and copy and paste them into this form.

If you have questions, please contact Amanda Smithey at [email protected].

Nomination Form

Student Information - Step 1 of 3

Home Arts Honors

Personal Information

Scholarship applying for (pick one)*

Lyle B. Wright
Richard H. Gorsuch

Student's Name

First

Last

Student's Email Address

Student's Phone

Student's High School

Student's Intended Post-Secondary School

Student's Anticipated Field of Study

Student's Parent's / Guardian's Name

First

Last

Student's Parent's / Guardian's Name

First

Last

Student's Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Activities and Achievements

Enter your detailed information in each of the following sections, include the approximate dates/grade of your involvement and any offices held. For example: National Honor Society - 11th, 12th OR National Honor Society - 2024, 2025. Please only include involvements/achievements from High School.

Awards and Honors

All academic honors and awards, including any advanced placement/college classes, National Honor Society, honor roll, class valedictorian, etc.

Preferred format: Activities and Achievements, Offices Held, Dates

Awards and Honors

Academic Leadership and Participation

All academic involvement not covered under the arts, athletic and volunteer categories, including membership in science clubs, foreign language clubs, science fairs, student council, Boys or Girls State, newspaper, yearbook, internships, etc.

Preferred format: Activities and Achievements, Offices Held, Dates

Academic Leadership and Participation

Social/Volunteer Efforts

All social and volunteer efforts, both inside and outside of school, including participation in community events, 4-H, Junior Achievement, church, Y-Teens, Key Club, etc. Please include any awards or distinctions relating to your volunteer work.

Preferred format: Activities and Achievements, Offices Held, Dates

Social/Volunteer Efforts

Arts Involvement

All participation in artistic activities, both inside and outside of school, including band, choir, theater, church choir, dance, etc. Please include any awards or distinctions relating to your arts participation.

Preferred format: Activities and Achievements, Offices Held, Dates

Arts Involvement

Athletic Involvement

All participation in athletics, both inside and outside of school, including football, golf, basketball, track, soccer, cheerleading, etc. Please include any awards or distinctions relating to your athletic involvement.

Preferred format: Activities and Achievements, Offices Held, Dates

Athletic Involvement

Additional Information

If you have been involved in any activities that do not fit into one of the previous categories, please explain below.

Also, please use this space to describe any after-school jobs you have held.

Additional Information

High School Achievements

Please briefly explain your three biggest achievements during high school.

High School Achievements