Sojourner Truth Education & Resource Center
Student Accomplishment Form
Level (please check)
□Elementary School
Grade: __________
School: _______________________________________________________________________________________________
□Middle School
□High School*
Student’s Name: _______________________________________________________________________________________________________________
Parents’ Name: _________________________________________________________________________________________________________________
Contact Information: Phone #: ______________________ Alternate #: ____________________ Email: __________________________________
Academic Achievement: “Copies” of report cards must be attached if grades have not been verified via the Homework
Center.
Categories: Select only one for the entire school year. For example, if the student received all “As” one grade period but
“As” & “Bs” the other periods the student would check the “A/B” category. You may highlight the grading period(s) for
which the student received all “As” in the next section.
□ “A” Honor Roll or Highest marks for primary grades
□ “A/B” Honor Roll or equivalent for primary grades
□ “B” Honor Roll or equivalent for primary grades
Academic Honors: (Attach a separate sheet if necessary) ____________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Other Accomplishments/Recognitions: In this section you should also list positions the student has held in school
organizations as well as achievements in sports. (Attach a separate sheet if necessary)
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Planning for the future: Check all that apply
□ I am a rising senior and would like information about the MOF scholarship
□ I would like information about other college financial assistance
□ I would like information about enrolling in a community college or trade school
□ I’m unsure about my future plans and would like assistance with identifying career choices
*Graduating high school seniors should complete the senior accomplishment & scholarship form
A Monument of Faith Ministry
A Monument of Faith Ministry