What is the length of time estimated to complete your program of study? _________ months / years (circle one)
Starting with the most current, please list paid jobs and internships you have held during the past three years.
Specific nature of work Employer School Yr. /Summer Dates Hours per wk.
In order of importance to you, list up to five recognitions, honors or awards you have received during the last four years. Please be specific in recording the year of the award and who gave the award.
Year(s) Recognition, Honor or Award _______ _____________________________________________________________________________
On the following pages please list your principal extracurricular, community and volunteer activities in addition to your unpaid internships over the last four years, beginning with the current school year. Do not includeany hours spent in classroom time. For example, do not include band class hours but do include band practice hours spent before or after regular school hours.
To allow us to focus on the highlights of your career, please list in this section only the ten activities you have spent
the most time on during this four year period. If you do not have ten, that is okay. This section must be filled out even if you choose to attach a resume’ showing all of your activities. If you do not have a record of exact hours spent, you may estimate (there are approximately 36 weeks in a school year and 12 weeks in a summer; for example, use this formula: Hours per wk. X Total Wks. X Total Yrs. = Total Hours ).
Leadership Role (if any) _____________________________________________________________________
Section 7—Short Answer What activity, volunteer position or job have you participated in over the last 4 years that is related to or preparing you for your career goal? Explain. __________________________________________________________________________
(to be written by a counselor, pastor, employer, teacher or professor )
The following individual has applied for an Auxiliary scholarship to further his/her education and has named you as a person who might evaluate his/her suitability for this scholarship. Under a separate sheet, please write your recommendation which should include information concerning the applicant’s character, activities, work ethic, attitude and other pertinent facts touching upon his/her past achievements and future potential.
Please include your name, title, and contact information including phone number and email address. Your recommendation can be submitted in any format you choose, and you are not required to return this Instruction Sheet. Your comments will be most helpful in the scholarship selection process and will be kept