FORT BEND COUNTY A&M UNIVERSITY MOTHERS’ CLUB



FORT BEND COUNTY A&M UNIVERSITY MOTHERS’ CLUB SCHOLARSHIPBIOGRAPHICAL INFORMATION COVER SHEETPrior to the selection process, this cover sheet will be removed to ensure anonymity. The Fort Bend County A&M University Mothers’ Club (Ft. Bend Aggie Moms’ Club) shall hold all information provided herein confidential.Name (Last, first, middle initial) _______________________________ Date of Birth __________Permanent Address ________________________________________Street or P.O. Box Apartment # ________________________________________CityStateZip Code`TAMU(G) or Blinn Identification Number (UIN)_________________Address at TAMU(G) ______________________________________Street or P.O. Box Apartment # __________________________________________CityStateZip Code`TAMU(G) Email Address _______________________________Parent Name(s) ___________________________ Parent Phone _____________________Parent Email Address __________________________________Campus (College Station, Blinn, or Galveston) ____________________________________High School District _______________________ High School Zip Code ________________High School Graduated From _____________________________ Graduation Date (MM/YY) _____ I attest to the accuracy of the information provided and that I am a U.S. citizen or eligible non-citizen as defined by the U.S. Department of Education criteria for receiving federal financial assistance. In addition, my digital acknowledgment below indicates that I have read the Scholarship requirements on the accompanying sheet.I understand that the Ft. Bend Aggie Moms’ Club may substantiate any of the data provided herein. False statements will be cause for immediate disqualification or cancellation of the scholarship. Applicant Acknowledgment (Name) _____________________________Date __________________(Typed Name is sufficient for ‘electronic signature’ submission)FORT BEND?COUNTY?A&M?UNIVERSITY?MOTHERS’?CLUBSCHOLARSHIP?APPLICATIONType all responses using the table entry formats below each response. Handwritten applications will not be accepted. Add rows below each table if additional response lines are required. Completed applications must be emailed from the student’s TAMU email address to the scholarship committee email on or before the deadline specified in the application instructions. An acknowledgement will be sent the student TAMU email address provided on the application within ten days of receipt of completed application including the transcript. If you do not receive such confirmation, contact the Scholarship Committee at: scholarshipfortbendaggiemoms@ or Krista Smith, 713-832-5435 and arrange to re-send the application. Note that this must be accomplished within the February 9, 2020 deadline! Both the scholarship application and transcript must be received by 11:59 p.m., Sunday, February 9, 2020. Incomplete applications will not be considered on time even if they are received by the deadline. 1)??SEMESTER HOURS?CURRENTLY?ENROLLED _______ MAJOR?FIELD?OF?STUDY?________________________ CAMPUS (COLLEGE STATION OR GALVESTON) __________________ ANTICIPATED SEMESTER & YEAR OF GRADUATION _________________2)??TAMU?SPONSORED ORGANIZATIONS?AND?EXTRACURRICULAR?ACTIVITIES: List all organizations and extracurricular activities in which you have participated while a student at Texas A&M University with dates of membership and name of faculty / staff sponsor and their contact anization / Activity NameDates of Participation mm/yy to mm/yyFaculty / Staff Sponsor (Name, telephone and/or email contact information)1 2 3 4 5 6 3) TAMU?LEADERSHIP?POSITIONS?HELD: List all University sponsored leadership positions held while a student at Texas A&M University with dates, responsibilities and whether elected or appointed. PositionDates of Term mm/yy to mm/yyElected or AppointedResponsibilities1 2 3 4 5 6 4)??TAMU?SPONSORED?SERVICE: Describe all campus or community service performed while a student at Texas A&M University with sponsoring organization, dates of participation, position description, time required, and paid or unpaid. Sponsoring OrganizationDates of Participation mm/yy to mm/yyPaid/ UnpaidTotal Number of Hours RequiredPosition123456?5)??TAMU?HONOR?SOCIETIES/ORGANIZATIONS,?HONORS?AND?AWARDS: Describe all honor societies or organizations to which you have belonged and honors or awards received while a student at Texas A&M University. For awards include awarding entity and date. Honor Society/ Organization NameDate of Award mm/yy Staff/Faculty Sponsor Name (if known)Honor or Award NameDescription of Honor / Award1234566)??NONTAMU?ORGANIZATIONS?AND?EXTRACURRICULAR?ACTIVITIES: List all organizations and extracurricular activities (not university sponsored) in which you have participated while a student at Texas A&M University with dates of membership and name of sponsor. Organization / ActivityDates of Participation mm/yy to mm/yyStaff/Faculty Sponsor NameDescription of Organization / Activity1234567) NONTAMU LEADERSHIP POSITIONS HELD: List all non-university sponsored leadership positions held while a student at Texas A&M University with dates of responsibilities and whether elected or appointed. Organization / ActivityPosition HeldElected or AppointedDate of Term mm/yy to mm/yyDescription of Responsibilities123456 8)??NONTAMU?SPONSORED?SERVICE: Describe all non-university sponsored community service performed while a student at Texas A&M University with name of sponsoring organization, dates of participation, amount of time required and paid or non-paid service, and description of service performed. Sponsoring OrganizationDates of Participationmm/yy to mm/yyPaid or Un-PaidTotal Number of Hours RequiredDescription of Service Performed 1234569)??NONTAMU?HONORS,?AWARDS,?HONOR?SOCIETIES/ORGANIZATIONS: Describe all non-university sponsored honors societies or organizations to which you have belonged and any honors, awards, or recognition received while a student at Texas A&M University. For awards include awarding entity and date. Honor Society/ Organization NameDates of Participationmm/yy to mm/yyHonor or Award Name (if any) Leave blank if none.Date of Honor or Award Description of Organization / Activity / Honor or Award12345610) EMPLOYMENT: List any paid employment including company name, phone number and number of hours worked per week and indicate whether or not employment was concurrent with TAMU academic semesters. Do not include high school pany NameJob Position TitleDates of Employmentmm/yy to mm/yy# Hours worked per weekEmployed while a full-time student at TAMUBrief Description of Job Responsibilities12345611)?INTERNSHIPS?AND?CO-OPS: List any internships or co-ops in which you have participated or are currently employed, dates of employment, paid or unpaid, and whether required for degree plan. Company NameDates of Employmentmm/yy to mm/yy# Hours worked per weekPaid or UnpaidRequired for Degree Plan (Yes or No)1 2 3 45612)?SCHOLARSHIPS,?GRANTS?AND?ENDOWMENTS: List all scholarships, grants or endowments awarded by any source for your education while attending Texas A&M University. An academic year is defined as the Fall, Spring and Summer semesters. Award Name andAwarding EntityAcademic years of Award20__ to 20__Indicate Fall / Spring / Summer (all that apply)Total amount of Award per academic yearAutomatically Renewed? Yes or No1 $ 2$ 3$ 4$ 5$ 6$ 7$ 8$ 13) PERSONAL/FAMILY?FINANCIAL?HARDSHIP: Describe any personal, family or financial hardship (if any) that we should consider when evaluating this scholarship application. 3048054610List any personal/ family /financial hardships here. 00List any personal/ family /financial hardships here. 14) ESSAY QUESTIONS: Answer any two (2) of the following questions in essay form (no more than 250 words for each). Indicate essay question number and type responses in the space below. Possible New Essay Questions:Describe a time where you demonstrated leadership. How did this affect the outcome?Describe the greatest challenges that you believe college students will face in the year 2050? Describe your superpower and what you plan to do with it after you graduate from TAMU.If you could be any person in history, who would it be and why?Describe one of your quirks and why it is part of who you are.1. Essay Question Number: _____ Essay Response: 2. Essay Question Number: _____ Essay Response: ................
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