Scholarship Application Template 2003



The applications will be reviewed and a recipient selected by a committee consisting of school and community members. The scholarship will be awarded at the May 20 Academic Honors Night.

Please complete Pages 1 and 2 of this application form just once. Following it are the specific prompts for the three scholarships listed above. You may apply for all three or any one of them that you wish. Return all applications to Mr. Houser at john.houser@fwcs.k12.in.us by April 24, 2020.

Scholarship APPLICATION 2020

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|Please type or print your answers. |

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|1. |Last Name: |First Name: |

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| |Mailing Address |

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| |Street: |

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| |City: State: Zip: |

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|3. |Daytime Telephone Number: ( ) |

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| |Email Address: |

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|4. |Cumulative Grade Point Average (GPA): __________ (On a 4.33 scale) |

|5. |List any academic honors, awards, and membership activities you have received while in high school. You may attach a separate sheet if you have already prepared |

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| |List Leadership and Service opportunities that you have completed: |

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| |School |

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| |Community |

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|8. |Please list the college/educational institution you will be attending in the Fall of 2018. (The check will be made out to that institution). |

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| |Name & address of parent(s) or legal guardian(s): |

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| |(Include address if different than your own listed in Question 2.) |

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| |Name(s) : |

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| |Street: |

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| |City: State: Zip: |

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| |Home phone of parents or legal guardians: Work phone: |

All Essays should be TYPED (feel free to expand the box) or on another sheet of paper.

Dr. Hans Sheridan Leadership Scholarship

10. You may use a separate sheet of paper or answer the question below:

Explain the importance and benefits of leadership in your school and community, and share how you have shown leadership at Wayne High School and/or in your community.

Tammy Doss PTSA Scholarship

11. You may use a separate sheet of paper or answer the questions below:

Describe how volunteer work or community service has shaped who you are today as well as how you plan to make service to community part of your future.

Mellannie Bishop Memorial Scholarship

Describe 2-3 priorities in your life and explain how investment in those areas of your life have impacted you and will guide you as you move forward as a student and as a member of the community.

STATEMENT OF ACCURACY FOR STUDENTS

I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that if chosen as a scholarship winner my picture may be taken and published in the Wayne Newsletter, Mad About Wayne.

I hereby understand that if chosen as a scholarship winner, it is my responsibility to remit to the Guidance Office my letter of acceptance from my chosen college prior to receiving my award.

I hereby understand I will not submit this application without all required attachments and supporting information. Incomplete applications or applications that do not meet eligibility criteria will NOT be considered for this scholarship.

Signature of scholarship applicant: ___________________________________ Date: ___________________

STATEMENT OF SUPPORT BY GUIDANCE COUNSELOR

Name of Guidance Counselor submitting the application: ________________________________________________

Signature of Guidance Counselor: ____________________________________

Date: _________________

Checklist

___ Application

___ Completed Essay

___ Guidance Counselor signature

COMPLETE APPLICATION PACKAGE AND RETURN TO:

John.Houser@fwcs.k12.in.us

REMINDER:

The deadline for this application is:

April 24, 2020

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