LADY LEGACY SCHOLARSHIP FOUNDATION



LADY LEGACY SCHOLARSHIP FOUNDATION

SCHOLARSHIP APPLICATION

Eligibility Requirements

Candidate must be:

1) a female who is a resident of the counties of Blount, Jefferson, Shelby, St. Clair, Walker or Tuscaloosa, and has an interest in golf

2) a graduate of an accredited secondary school where she has shown evidence of academic excellence, good citizenship and sportsmanship, and a minimum ACT score of 22

3) in need of financial assistance to pursue an undergraduate degree as a full-time student in a four-year Alabama college or university accredited by the Southern Association of Colleges.

The amount of the scholarship will be paid directly to the accredited institution of the applicant’s choice in the state of Alabama.

The recipient must maintain at least a C+ (2.4 out of 4) her freshman year and a B- (2.8 out of 4) thereafter. If funds are available, other scholarships will be considered. The decision of the Lady Legacy Scholarship Board of Directors will be based on the submitted material and a personal interview. Candidate must provide from parents’ previous year’s tax return a copy of the page indicating Adjusted Gross Income.

Instructions

1. Fill out application completely. Please type or print legibly.

2. Two (2) letters of recommendation from your high school staff, work-related supervisor, and/or local LBGA member.

3. A copy of your SAT scores, math and verbal, and your ACT scores must be submitted.

4. A copy of your high school transcript must be included.

5. The financial statement must be signed by your parent or guardian. Attach from previous year’s tax return a copy of the page indicating Adjusted Gross Income. Parents’ Social Security numbers may be redacted.

6. NEW Deadline: The application and all pertinent data must be mailed by March 11 to:

Kathy Baggio

3621. River Ridge Road

Birmingham, AL 35243

ALL INFORMATION WILL REMAIN CONFIDENTIAL

LADY LEGACY SCHOLARSHIP FOUNDATION

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Scholarship Application Form

PART I PERSONAL INFORMATION

Name

Last First

Name you prefer to be called _________________________ Social Security No

Home Address ________________________________ _________________ ___

Street City St Zip

Home phone__________________ ____Cell____________ ___ County__________________

E-mail Address

Birth Date

Name of parent(s) or guardian(s) with whom you live

Are your parents living? _________ Divorced? __________ Separated?

What college, if any, did they attend?

Do you have brothers/sisters? If so:

Name ______________________ Age ________School ____________________ Grade

Name ______________________ Age ________School ____________________ Grade

Name ______________________ Age ________School ____________________ Grade

Name ______________________ Age ________School ____________________ Grade

ALL INFORMATION WILL REMAIN CONFIDENTIAL

LADY LEGACY SCHOLARSHIP FOUNDATION

PART II FINANCIAL REPORT

Father’s Occupation _____________________ Employer __________________ Annual Salary

Mother’s Occupation ____________________ Employer __________________ Annual Salary

Estimate of Parent’s contribution to college expenses per year

If parents are separated or divorced, will you receive assistance from the parent with whom you do not live? _________________ How much?

Amount other relatives will contribute to your college support.

Do your parents own their own home?

Are there any extraordinary expenses in your family? (illnesses, debts, etc.) Explain:

Have you applied of other scholarship aid? List:

Have you been granted scholarship aid? List:

Do you plan to work while at college? Full time _____ Part time ____ Work/study program

ALL INFORMATION WILL REMAIN CONFIDENTIAL

LADY LEGACY SCHOLARSHIP FOUNDATION

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PART III CURRENT EDUCATION AND ACTIVITIES

Name of your High School _________________________________ Principal ________________

Address

Street City Zip City St Zip

Senior Counselor’s Name _________________________________ School Telephone ______

GPA ________ Class Rank _______ Class Size _______ ACT

Academic Clubs

Academic Awards

High School Offices Held

Community Activities

Golf and Other Athletics

Average Golf Score or Handicap

What Golf events have you played in (local, high school, state, national)

What part-time or full-time jobs have you had?

Employer Dates Hrs/Week Salary

ALL INFORMATION WILL REMAIN CONFIDENTIAL

LADY LEGACY SCHOLARSHIP FOUNDATION

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PART IV COLLEGE EDUCATION

Your choice of Alabama college for Lady Legacy Scholarship: __________________________________

Have you applied for admission? __________ Have you been accepted? _____________

What field of study do you plan to pursue? __________________________________________________

Please write a 200 word statement explaining why a college education is important to you.

If selected, I authorize Lady Legacy Scholarship Foundation to use my name and photograph, and I agree not to hold Lady Legacy Scholarship Foundation liable for any such use.

Signature of Applicant Date

Signature of Parent/Guardian Date

APPLICATION MUST BE SIGNED BY BOTH APPLICANT AND PARENT/GUARDIAN.

ALL INFORMATION WILL BE CONSIDERED CONFIDENTIAL.

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