MIDWEST MEMORIAL SCHOLARSHIP FOUNDATION SCHOLARSHIP APPLICATION. Application Deadline: May 11, 2016
TMA CHICAGO/MIDWEST MEMORIAL SCHOLARSHIP FOUNDATION SCHOLARSHIP APPLICATION Application Deadline: May 11, 2016 Submit to: P.O. Box 33, Frankfort, IL 6...
TMA CHICAGO/MIDWEST MEMORIAL SCHOLARSHIP FOUNDATION SCHOLARSHIP APPLICATION Application Deadline: May 11, 2016 Submit to: P.O. Box 33, Frankfort, IL 60423
WHO CAN APPLY Any student pursuing a post high school education (including all trade and professional schools). Scholarships will not be awarded for post-graduate educations. Please note, past scholarship recipients are not eligible to win a second scholarship.
CONTACT INFORMATION Name _________________________________________ Birth date __/__/____ Street Address___________________________________ City, State & Zip Code _____________________________ Male/Female _______ Phone Number __________________ E-mail Address _____________________ Names of Parent/Guardian ____________________________________________ Street Address___________________________________ City, State & Zip Code _____________________________ Relationship ________ Phone Number __________________ E-mail Address ______________________ Names of Parent/Guardian ____________________________________________ Street Address___________________________________ City, State & Zip Code _____________________________ Relationship ________ Phone Number __________________ E-mail Address ______________________
HIGH SCHOOL EDUCATION High School _______________________________________________________ Is your high school public or private? ____________________________________ 1. Class Rank ___________ How many students are in your graduating class? ________ 2. Grade Point Average _____ What number scale is this on? _____ Please provide high school transcript. 3. SAT Score Total __________ Math __________ Verbal _________ 4. ACT Score________
HIGH SCHOOL EDUCATION (CONTINUED) List/describe any scholastic honors or awards you have received in high school. (Attach additional pages if necessary.) 1. 2. 3. 4.
List extracurricular activities, including any volunteer or community work while in high school. (Attach additional pages if necessary.) Activity
Position Held
Years Involved
POST HIGH SCHOOL EDUCATION (Complete if you have ever attended a post high school educational institution.) Please provide the name, location, years attended and your grade point average for all post high school educational institutions attended. Please provide school transcript. Name/City and State where located
Years Attended
Grade Point Average
List/describe any scholastic honors or awards you have received from a post highschool educational institution. (Attach additional pages if necessary.) 1. 2. 3. 4.
POST HIGH SCHOOL EDUCATION (CONTINUED) (Complete if you have ever attended a post high school educational institution. List extracurricular activities, including any volunteer or community work at any time after high school graduation. (Attach additional pages if necessary.) Activity
Position Held
Years Involved
Job Title/Description
Dates of Employment/Average hours worked per week
EMPLOYMENT
Place of Employment
SCHOOL PLANS What school will you be attending? _________________________________________ Have you been accepted? __________________________________________ What is the yearly tuition? __________________________________________ What is the estimated total cost per year? _______________________________ What major or curriculum do you plan on pursuing? ____________________________ How many credit hours do you plan on taking for the upcoming academic year? ______ What activities do you anticipate being involved with while attending school (e.g. student government, band, athletics, etc.)? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
3
GRANTS/SCHOLARSHIPS/LOANS List any grants/scholarships/loans you have applied for and are either awaiting status of or have received.
Name of Grant/Scholarship/Loan
Amount Applied For or Awarded
Status (Received/Still Pending)
How do you presently anticipate paying for the year of school for which you are applying? Source of Funds Parents Friends/Relatives Students Own Earnings Scholarships/Grants Loans Other (specify)
ESSAY Discuss in 500 words or less your educational goals, objectives and accomplishments and explain why you should be awarded a scholarship. (Attach additional pages if necessary.)
4
LETTERS OF RECOMMENDATION Please attach two (2) current (within last 12 months) letters of recommendation.
SPONSOR Please provide your sponsor’s name, phone number/e-mail address:_______________ ______________________________________________________________________ How is your sponsor related to the corporate renewal industry (required):___________ ______________________________________________________________________ ______________________________________________________________________ How did you hear about the scholarship program:______________________________ ______________________________________________________________________
CERTIFICATION I hereby certify that all information provided in this application is accurate, true and correct, and that I plan on attending the institution indicated on a full time basis for the academic year for which the scholarship is being applied. Date: ____________________
CHECKLIST: Completed Scholarship Application Two current (last 12 months) letters of recommendation Certified transcripts of high school and post-high school (if applicable) through December 31, 2015 Essay not to exceed 500 words Name of sponsor, sponsor’s contact information and how the sponsor is related to the corporate renewal industry (required)
