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