Instructions: print this page, complete it, and mail with required documentation to AHSHA, PO Box 64383
Phoenix, AZ 85082-4383
.


Arizona High School Hockey Association

Stephen Daniel Demchik Memorial Scholarship

The Arizona High School Hockey Association, through the support of Behind the Mask, created an academic scholarship award in memory of Stephen Daniel Demchik, a player in the Thunderbird High School hockey program, who died in a hiking accident on August 3, 2006.

Players who are current high school seniors are eligible to apply for this award. AHSHA’s nominating committee will determine the recipient based on documentation of the applicant’s qualities of academic success, civic character, leadership, and fair play.

The deadline for nominations is (postmarked) March 15 (or next business day if 15th is a Sunday)

Player’s Name:


Date of Birth:


Phone number:


Email address:


Mailing Address:


City, ST Zip:


Current/cumulative GPA (Please provide school-issued documentation):

On-Ice and/or Off-Ice Leadership Roles:

Educational plans after High School:

High School Hockey Team:

School name, if different:

Name and contact info of Coach/Manager:

Position Played:

# of years played with AHSHA:

Statistics (G, A, Pts, PIM or GAA, Save %, Record):

Please provide a brief essay explaining why you believe you should receive the award, with attention paid to qualities of academic success, civic character, leadership, and fair play. Use a separate or additional sheet if necessary.



























Please submit completed form to AHSHA.

Forms must be postmarked by March 15. (or the folloiwng Monday if a Sunday)


AHSHA
PO Box 64383
Phoenix, AZ 85082

Fax to 602-952-2524

Note: if you have problems with this form, please contact AHSHAadmin@cox.net or 602-799-7447.