CAAT 2005 Youth Scholarship Application Form (Please Print)
(Please mail this Form and the School Report to CAAT, PO Box 47614, Tampa, FL 33647 by June 30)
Last Name	First Name	Social Security No.		e-mail address

School Name			Grade	GPA

Home Address (Please do not use P.O. Box)

CAAT Registration Information
Member's Name (Last, First)				e-mail address

Please write a short essay summarizing what have you done to local society, especially to local Chinese society? (less than 50 words)





Community Service, Including CAAT Activity Hours (Please attach sheets if additional space is needed)
Date	Activities			Verified By







Signature			Date
FOR CAAT BOD USE ONLY: Review Comments			Date