CAAT 2005 Youth Scholarship Application Form (Please Print)
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