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GENERAL SCHOLARSHIP APPLICATION 2021Name (First Last):____________________________________________________Please check your high school below. If you attend one of these Linn County high schools, apply for any scholarships listed below with this application submitted to the Community Foundation. _____Alburnett High School_____Lisbon High School_____Cedar Valley Christian School_____Metro High School_____Center Point-Urbana High School_____Mount Vernon High School_____Central City High School _____North Linn High School _____Springville High SchoolIf you attend Jefferson, Kennedy, Linn-Mar, Marion, Prairie, Washington, or Xavier:You can ONLY use this application to apply for the Komensky Society Scholarship. Apply at your high school guidance office for any other Community Foundation scholarships.Check below to indicate the scholarship(s) for which you are applying:Scholarships available to Linn County high school seniors:Merveaux Academic Excellence ScholarshipGlidden Community Service ScholarshipOutstanding Student Leader ScholarshipOther scholarships (based partly on financial need) available to Linn County high school seniors:College Opportunity Scholarship: Selection based on financial need and career goalsKalous Opportunity Scholarship: Selection based on financial need, character, and career goalsKomensky Society Scholarship: For students of Czech or Slovak heritageDetails about all scholarships’ eligibility requirements, criteria, and award amounts are in “Applying for Scholarships” at 4796155881359700Note: submit ONE application for the scholarship(s) for which you are applying. Your completed application with all required documents must be received at scholarships@, by 4:30 pm on Friday, February 26, 2021. Section 1: Applicant InformationName (First Last):__________________________________________Date of Birth (M/D/YY): Street Address/City/State/Zip:_________________________________________________________________________Student email address: __________________________________________________ Student cell phone:Student home phone: Section 2: Academic InformationHigh school:Graduation Date: Counselor’s name:____________________________ Counselor’s email address:________________________Grade Point Average: Rank in Class: out of a class of: ________ College planning to attend:Planned major field of study:_____________________________________________Section 3: Family InformationParent/guardian 1:______________________________________________________Guardian 1 occupation:___________________________________________________Guardian 1 employer:____________________________________________________Parent/guardian 2:______________________________________________________Guardian 2 occupation:___________________________________________________Guardian 2 employer:____________________________________________________Number of siblings currently attending college:________________right883710500By submitting this application, I certify that the information contained therein is true and complete to the best of my knowledge and understand that false information or omission of data may result in denial of my application. I understand that the information submitted will be considered confidential in review by the Greater Cedar Rapids Community Foundation and members of the Scholarship Advisory Committee. If chosen for a Community Foundation scholarship award, I agree to complete the Scholarship Recipient’s Agreement Form and return it to the Community Foundation office. I understand that if I do not return a completed agreement, my scholarship funds will be awarded to the selected alternate. I also agree that my name can be used in announcements made by the Community Foundation regarding the particular scholarship(s) for any scholarship that I may be awarded. Signed: ___________________________________________ Date: ___________________________________Section 4: School & Volunteer ActivitiesOn separate page(s) include the following information for both school and volunteer activities in which you have participated:OrganizationStart dateEnd dateRoleSection 5: Work/Business ExperienceOn separate page(s) include the following information for work/business activities in which you have participated:OrganizationStart dateEnd dateRoleSection 6: Personal Essay On separate page(s) include a brief essay (200-300 words) describing yourself, including personal aspirations, educational and career goals. Section 7: Required Documents for all applications:Include the following with your application:Academic Transcript Academic letter of reference (Letter from teacher, counselor, administrator, etc)Non-academic letter of reference (Letter from employer, volunteer supervisor, etc)Section 8: Required Documents for scholarships based partly on financial need (College Opportunity, Kalous Opportunity, Komensky):EFC from FAFSA (the one-page Statement of Estimated Family Contribution (EFC) from your completed Free Application for Federal Student Aid (FAFSA). Do not include your entire FAFSA application.)Financial circumstances: On separate page describe (100-200 words) your circumstances of financial need and plan for paying college costs. Also required for Komensky: On separate page describe (100-200 words) how your Czech, Slovak, or Moravian heritage has impacted your life.Please be careful to ascertain that you meet the eligibility requirements and criteria for the scholarship(s) for which you are applying and to include all required information with your application. 4796155891941300 Your completed application with all required documents must be received at scholarships@, by 4:30 pm on Friday, February 26, 2021. ................
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