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Senior Scholarship Nomination Form

Head Coach Name*

Head Coach Email

Head Coach Sport

Student Information

Student First Name*

Student Last name*

Student Email*

Student Phone

Student Gender*

Student Address

Number of Years in this Sport*

% of Games/Practices Attended this Year*

% of Games/Practices Attended all Years*

Parent/Guardian Information

Parent/Guardian Name*

Parent/Guardian Email*

Parent/Guardian Address

Parent/Guardian Phone

Coach's Statement

Coach's Statement*

In 250 words or less, please explain why you believe this student-athlete is deserving of the award for which you are nominating them.*

By checking this box, I confirm I am the head coach of the nominated student-athlete. This confirmation serves as my signature.

The Berkeley Athletic Fund is a registered 501(c)(3) & our non-profit Tax ID # is 94-3006966.

Email us:

president@berkeleyathleticfund.net

Mail us:

P.O. Box 11525

Berkeley, CA 94712

© 2025 Berkeley Athletic Fund

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