Best&Brightest

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DEADLINE
FOR
PA Media Group
Mail or hand
deliver to:
Best & Brightest
The Patriot-News
SUBMISSION
2020 Technology Parkway,
Best & Brightest
IS 4:30Parkway
PM ON
Suite
300Technology
2020
DEADLINE FOR SUBMISSION IS MARCH 27, 2013
Mechanicsburg, PA 17050
Suite 300 MARCH 6, 2017

APPLICATION

(Postmark of March 6 is acceptable)

Full name ____________________________________________________________________________________________________________

Mechanicsburg, PA 17050

Date of birth ______________________________________________

Street address _______________________________________________________________________ City ________________________________________________ ZIP _________________________________

Home phone _______________________________ Cellphone _____________________________ Email address __________________________________________________
Borough or township in which you live _________________________________________________________________________________________________________________________________________
Names of parents or guardians (indicate which) _____________________________________________________________________________________________________________________________
School ____________________________________________________________________________________________________________ School telephone ____________________________________________

HONORS

Briefly describe
distinctions
oror
honors
youyou
have
won.
Briefly
describe scholastic,
scholastic, community,
community,athletic,
athletic,work-related
work-relatedororpersonal
personal
distinctions
honors
have
received.

SCHOOL
SCHOOL AND
AND COMMUNITY
COMMUNITY INVOLVEMENT
INVOLVEMENT

List
and
family
activities
and
interests
in order
of their
importance
to you.
Include
specific
events
List your
your extracurricular,
extracurricular,community,
community,volunteer
volunteer
and
family
activities
and
interests
in order
of their
importance
to you.
Include
specific
and/or
Follow this
format:
events major
and/oraccomplishments.
major accomplishments.
Follow
this format:
Activity
Activity

Grade level

Grade Level

10 11 12
9 10 11 12

Approximate time spent

Approximate time spent

Hours/week Weeks/year

Hours/week

Describe your role, including positions

Describe your role, including positions held,

held,
honors
presented
or letters
honors
presented
or letters
earnedearned

Weeks/year

ACADEMIC
ACADEMIC

Cumulative GPA
SAT scores:
____________________________
ACT scores: ____________________________
Cumulative
GPA:___________________________
________________ SAT scores:
__________________
ACT scores: _________________
Class rank if known: ________________

MENTOR (not
MENTOR
(notaaparent
parentor
orrelative)
relative)

Name one
teacherwho
(andhas
his/her
school)
has had
influence on you. Tell why.
Name
the person
had the
mostwho
influence
on the
you.most
Tell why.

WORK EXPERIENCE
WORK
EXPERIENCE

List any
any jobs,
jobs, including
includingsummer
summerjobs,
jobs,you
youhave
haveheld
heldduring
duringthe
thepast
pastthree
threeyears.
years.Follow
Followthis
thisformat:
format:
List
Specific nature of work

Specific nature of work

Employer

Employer

Dates of employment

Dates of employment

Number of hours/week

Number of hours/week

ESSAY
ESSAY
In 300 words or fewer, explain how you have made a difference in your school and/or community and how that experience will help you

In
500 words
fewer,society.
explainPlease
how you
difference you
in your
and/or community
and
howmay
thatbe
experience
contribute
to aorbetter
notehave
any made
speciala challenges
haveschool
surmounted.
Excerpts from
essay
published.will help you
contribute to a better society. Please note any special challenges you have surmounted. Excerpts from essay may be published.

PLANS
PLANS
Note plans beyond high school, schools you will be attending, etc.

Note plans beyond high school, schools you will be attending, etc.

RECOMMENDATIONS

RECOMMENDATIONS
Attach two typed, sealed letters of recommendation one from a teacher, counselor or principal at your school, the other from someone

Attach
typed,
letters
of recommendation
of 300 hundred
words
or choose
fewer asone
from a teacher,
or principal
outsidetwo
school
(notsealed
a relative).
Give
the following information
to the people
you
references.
To thosecoach,
writingcounselor
references:
In your letter
at your school; the other from someone outside school (not a relative). To those writing references: In your letter state how long you have
state how long you have known the applicant and in what context. Discuss the students contribution to his/her school and community, intelknown the applicant and in what context. Discuss the students contribution to his/her school and community, intellectual promise, ability
lectual promise, ability to overcome obstacles, leadership potential, special talents and enthusiasm. List your title, address, email address and
to overcome obstacles, leadership potential, special talents and enthusiasm. List your title, address, email address and phone numbers on
phone numbers on the letter. Excerpts from recommendations may be published.
the letter. Excerpts from recommendations may be published. Letters MUST be included with application and MUST be sealed.

SIGNATURES

REQUIRED
I verify that all SIGNATURES
the information I have provided is accurate, and I CONSENT TO THE PUBLICATION OF ANY INFORMATION IN THIS APPLICATION.
I verify that all the information I have provided is accurate, and I CONSENT TO THE PUBLICATION OF ANY INFORMATION IN THIS APPLICATION.
I agree to have my photo taken by a PennLive photographer and published by PennLive/The Patriot-News.

Signature of applicant

Signature of parent or guardian

Signature of applicant

Signature of parent or guardian

Signature of teacher

Daytime telephone of parent or guardian

Signature of a school administrator or guidance counselor

Daytime telephone of parent or guardian

QUESTIONS? Contact Lorenzo Falcone at 717-255-8148 or lfalcone@pennlive.com.

QUESTIONS? Contact Deb Kiner at 717-257-4749 or dkiner@pennlive.com

PR80248