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