Application for the
Haddam-Killingworth Hall of Fame
Eric Auer/Patsy Kamercia Student Civic Achievement Award
Achievement Award: $500
Haddam-Killingworth Hall of Fame
Eric Auer/Patsy Kamercia Student Civic Achievement Award
Achievement Award: $500
\A. General Information:
1. Applicant must be a resident of Haddam or Killingworth.
2. Awards are to be based upon applicant’s meeting one or both of the following criteria:
• Exemplary volunteer commitment to the service of the youth of Haddam and/or
Killingworth.
• Outstanding record of service to the community (Haddam and/or Killingworth).
3. Applicant must be a full time student in his/her senior year of high school and be planning
to attend a post-secondary educational institution in the fall of the same year.
4. No applicant will be considered for an award without submitting a completed
application to the committee, including the requirements below.
5. The application must be signed and dated. The application must be submitted to the
Counseling Office of Haddam-Killingworth High School by 3:00 pm on April 1, 2022.
6. The financial award will be made at the HKHS Scholarship Awards Ceremony in the spring.
B. The following data may be emailed to mchurch@rsd17.org or mailed to:
Haddam-Killingworth Hall of Fame Student Awards Committee
c/o Miranda Church, Guidance Department
Haddam-Killingworth High School
Higganum, CT 06441
C. Requirements
1. An essay of no more than 250 words describing yourself and the role you play in your
community, including your volunteer work with youth and/or other volunteer experiences.
2. An official transcript from your secondary institution (or the equivalent, if home schooled).
3. Two letters of recommendation (not from your parent) at least one of which comes from a
community member. The other may be from a current or former teacher, a counselor, or
coach.
4. Submission of completed, signed and dated application form.
5. A personal interview may be requested by the Committee at a mutually agreed time.
1. Applicant must be a resident of Haddam or Killingworth.
2. Awards are to be based upon applicant’s meeting one or both of the following criteria:
• Exemplary volunteer commitment to the service of the youth of Haddam and/or
Killingworth.
• Outstanding record of service to the community (Haddam and/or Killingworth).
3. Applicant must be a full time student in his/her senior year of high school and be planning
to attend a post-secondary educational institution in the fall of the same year.
4. No applicant will be considered for an award without submitting a completed
application to the committee, including the requirements below.
5. The application must be signed and dated. The application must be submitted to the
Counseling Office of Haddam-Killingworth High School by 3:00 pm on April 1, 2022.
6. The financial award will be made at the HKHS Scholarship Awards Ceremony in the spring.
B. The following data may be emailed to mchurch@rsd17.org or mailed to:
Haddam-Killingworth Hall of Fame Student Awards Committee
c/o Miranda Church, Guidance Department
Haddam-Killingworth High School
Higganum, CT 06441
C. Requirements
1. An essay of no more than 250 words describing yourself and the role you play in your
community, including your volunteer work with youth and/or other volunteer experiences.
2. An official transcript from your secondary institution (or the equivalent, if home schooled).
3. Two letters of recommendation (not from your parent) at least one of which comes from a
community member. The other may be from a current or former teacher, a counselor, or
coach.
4. Submission of completed, signed and dated application form.
5. A personal interview may be requested by the Committee at a mutually agreed time.
