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The New Liaison International Program Form

Complete the form and submit it now! You are one step away from your college scholarship opportunity!

FREE!

First Name

Last Name

Street Address

City

State/Country

Zip Code

Phone 1 and 2

Date of Birth

Country of Citizenship

Name of Parents or Guardian
Mother | Father | Guardian (list below)

Name and Address: School
Current High School or College:

Graduaton Date

Current Coach
Coach Name| Phone | Email (list below)

Academics
Current GPA| SAT Scores (Verbal Math Writing) | ACT Score (list below)

College Interest
List 3 Colleges Interested in:

Intended Major and Minor
List your intended Major and Minor:

Clearinghouse Registration?

Eligible for US Financial Aid?

Extracurricular Activities
List Activities and any Positions Held:

Track and Field Information
Events | Personal Best | Meet Location and Date

Achievements
Athletic| Academic (list below)

Personal Goals
Goals:

Agreement
By completing this form, I authorize U.S. Elite to use any information herein for purposes of helping me to seek scholarship opportunities and financial assistance for college. U.S. Elite is also permitted to use this information and my submitted picture in any way that is reasonable and necessary in assisting me and to promote the Liaison Program. I understand that by accepting the benefits of the Liaison Program, I automatically become a member of U.S. Elite. I also understand that the membership allows me to register and compete under USA Track and Field (USATF) organization, only with U.S. Elite during my collegiate years (with the discretion of my coach and NCAA college regulations) and post-collegiate years. This agreement is only valid in the United States of America.

Initials to Accept Agreement

Customer Service Information
If you have any questions or concerns, please contact Keishia Thorpe-Randolph, Director of the Liaison International Program, at 202-413-2699 or 240-770-8318 or via email keishiatd@yahoo.com. The mailing address is 1506 Brightseat Road #202, Largo, MD 20785

Jestina Daley Trust Scholarship Award

This scholarship is dedicated to helping students with financial hardships.

This scholarship will be awarded to students who have achieved outstanding performance and excellence in academics, athletics, and school and community citizenship.

This scholarship will be awarded to assist only with initial college expenses such as application fees, campus housing fees, and other educational related fees approved under NCAA regulations.

After completing and submitting the Liaison International Program Form on this page, please send an email to Keishia Thorpe, (Director) via keishiatd@yahoo.com if you wish to be considered for the scholarship.

If you experience any problems while submitting the form online, please send an email to keishiatd@yahoo.com to request a copy of the application form.

Sigma Tau Delta Independent Scholarship

This scholarship is made in dedication to Jestina Daley and offers the K&T Thorpe Award to the recipients selected each year. This scholarship has been established at University of Central Missouri, Livingstone College and Howard University, as a part of their scholarship program.

To apply for this scholarship, the recipient must be an active member and fulfill the requirements of the Sigma Tau Delta International English Honor Society. For more information, contact the respective colleges or send an email to keishiatd@yahoo.com.

Interested in Community Service Hours?

We are seeking VOLUNTEERS!! If you are interested in having fun with the team and serving your community, call now!! 202-390-6224 or send emails to uselitetrack@uselite.org

Students will also be able to earn community service hours to fulfill their school service requirement.

High Schools and Colleges in the Program

St. Andrew High School (for Girls)

Alpha Academy

Largo High

University of District of Columbia

North Carolina A&T University

Fort Valley State University

Johnson C. Smith University

Morgan State University

Georgia State University

Lincoln University (MO)

St. Augustine College

Blackhead University

Livingstone College

St. Peters College

Benedict College

Allen University