Etmc-quitman High School Auxiliary Scholarship Application
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- 2015-16 ETMC-Quitman High School Auxiliary Scholarship Application
- Section 2 – Financial Information
- Name Age Relationship School Attending
- Section 3 – For Current Seniors or Jr. Volunteer Applicants Only
- Section 4 – Other Scholarships/Grants/Loans for ALL Applicants
- Section 5 – Honors and Awards for ALL Applicants In order of importance to you
- Year(s) Recognition, Honor or Award
- Section 6 – Activities for High School
- Year(s) Total Hours Spent Term
- ETMC-Quitman Auxiliary Scholarship Recommendation Instruction Sheet (to be written by a counselor, pastor, employer, teacher or professor )
- Mailing Address
- ETMC-Quitman Auxiliary Scholarship Recommendation Form
- To be completed by an ETMC-Quitman Auxiliary Volunteer (for junior and shift volunteers only) or
2015-16 ETMC-Quitman High School Auxiliary Scholarship Application * Illegible applications or applications not containing all of the required information and documentation will not be considered. Section 1 – Personal Data Name: ______________________________________________________ Sex: Male Female (circle) Date of Birth: ___________________________ Primary Language Spoken at home: _________________________ Do you reside with your parent(s)? Yes No (circle) Permanent Address: ___________________________________________________________________________ City: ___________________________________________________________ Zip Code: ___________________ Mailing Address: ______________________________________________________________________________ City: ___________________________________________________________ Zip Code: ___________________ Home Phone: _____________________________________Cell Phone: __________________________________ Email Address: ________________________________________________________________________________
Are you totally dependent on your parents/guardian? Yes No (circle) If no, what amount/type of support do you receive? _________________________________________________ Father’s Name: _____________________________________ Occupation: ____________________________ Mother’s Name: _____________________________________ Occupation: ____________________________ Number of other dependent(s) of your parents/guardian: ________________ Name Age Relationship School Attending _______________________ __________ __________________ ________________________________ _______________________ __________ __________________ ________________________________ _______________________ __________ __________________ ________________________________ _______________________ __________ __________________ ________________________________
$________ tuition/ $________ books/ $________ room & board/ $________ fees/ $__________total cost What is the length of time estimated to complete your program of study? _________ months / years (circle one)
_______________________ __________________ __________ ___________ _______________________ __________________ __________ ___________ _______________________ __________________ __________ ___________ _______________________ __________________ __________ ___________ Are you employed now? Yes / No (circle one) What is your monthly salary? $ _________________ Section 3 – For Current Seniors or Jr. Volunteer Applicants Only High School NOW Attending: ___________________________________________________________________ Date of High School Graduation: ____________________________ Class Rank: ________out of _________ Are you graduating with college credits? Yes No (circle) If so, how many? __________________ High School cumulative GPA (>3.0): _____________________ SAT: _____________ ACT: _______________ College you would like to attend: _________________________________________ Accepted? __________ Section 4 – Other Scholarships/Grants/Loans for ALL Applicants Please list all other scholarships, grants and/or loans you have applied for or received for the upcoming school year. Name Applied or Received Notification Date Amount $$ 1. ___________________________________ _______________________ _______________ __________ 2. ___________________________________ _______________________ _______________ __________ 3. ___________________________________ _______________________ _______________ __________ 4. ___________________________________ _______________________ _______________ __________ 5. ___________________________________ _______________________ _______________ __________ Section 5 – Honors and Awards for ALL Applicants 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 include any 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 ). .
_______ _______ _______ _______ Activity __________________________________________________________________________________ Leadership Role (if any) _____________________________________________________________________ _______ _______ _______ _______ Activity _________________________________________________ _________________________________ Leadership Role (if any) _____________________________________________________________________ _______ _______ _______ _______ Activity _________________________________________________ _________________________________ Leadership Role (if any) _____________________________________________________________________ _______ _______ _______ _______ Activity _________________________________________________ _________________________________ Leadership Role (if any) _____________________________________________________________________ _______ _______ _______ _______ Activity _________________________________________________ _________________________________ Leadership Role (if any) _____________________________________________________________________ _______ _______ _______ _______ Activity _________________________________________________ _________________________________ Leadership Role (if any) _____________________________________________________________________ Year(s) Total Hours Spent Term School Yr. Summer _______ _______ _______ _______ Activity _________________________________________________ _________________________________ Leadership Role (if any) _____________________________________________________________________ _______ _______ _______ _______ Activity __________________________________________________________________________________ Leadership Role (if any) _____________________________________________________________________ _______ _______ _______ _______ Activity __________________________________________________________________________________ Leadership Role (if any) _____________________________________________________________________ _______ _______ _______ _______ Activity __________________________________________________________________________________ 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. __________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________
ETMC-Quitman Auxiliary Scholarship Recommendation Instruction Sheet (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 confidential. APPLICANT: _______________________________________ Questions: Debby Keenan, Scholarship Chairman (903) 383-5064 or ddktk@verizon.net Judy Johnson, President of ETMC-Quitman Auxiliary (903) 383-3433 or judydougj@yahoo.com Mailing Address: Auxiliary Scholarship Chairman c/o Volunteer Services ETMC-Quitman Auxiliary 117 N. Winnsboro Street Quitman, Texas 75783 Postage paid return envelope provided will be provided by applicant. High School Application Deadline: Postmarked on or before April 20, 2015. ETMC-Quitman Auxiliary Scholarship Recommendation Form
(To be completed by an ETMC-Quitman Auxiliary Volunteer (for junior and shift volunteers only) or Directory: upload -> page page -> Academic Vocabulary Argumentation Terms page -> Academic Vocabulary Argumentation Terms page -> E. E. Cummings Emily Dickinson page -> What was the environment in which you were raised? Describe your family, home, neighborhood, or community, and explain how it has shaped you as a person page -> Scholarships gordon a rich Memorial Scholarship Due February 20, 2017 page -> Back to school: Free software can help with studies page -> Main Idea & Supporting Details page -> Bay of Bengal Sierra Madre M page -> Who can be nominated page -> Beowulf Essay Bonus Download 171.06 Kb. Share with your friends:
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