Assistance League of Montgomery County
Assistance League of Montgomery County
Texas Public College/University Scholarship Application
AND
Texas Public Community College Scholarship Application
Complete the information below by clicking in the area provided and typing your answers. Spacing will increase as the information is typed, so that there is sufficient space for answers. For “Yes” and “No” answers, please type an “X” in the appropriate area.
GENERAL INFORMATION
Date:
I am applying fora: Four-year Institution Two-year Institution ______
Full Name: E-Mail:
Are you a U.S. citizen?Yes No
Cell Phone: Home Phone:
Street Address:
City: Zip Code:
Name of High School:
Name of School District:
Father’s/Guardian’sName:
Father’s/Guardian’sOccupation:
Mother’s/Guardian’s Name:
Mother’s/Guardian’sOccupation:
Parent’s Address:
Parent’sPhone: Parent’sE-Mail Address:
Number of family members/peopleliving inyourhome: Adults: (18 years or older)
Children: (under 18)
Number ofindividuals in your family who will be in college next year, including yourself?
STUDENT INFORMATION
College or University you plan to attend:
Have you been accepted? Yes No
Major:
Minor, if any:
Your career goal:
Have you applied for other scholarships? Yes No
Have you been offered other scholarships?Yes No
If Yes, did you accept? Yes No
If No, please explain. ______
List below other scholarships offered and acceptedalong with the amount of each:
1)Amount: Organization:
2)Amount: Organization:
3)Amount: Organization:
EXTRACURRICULAR ACTIVITIES –Please list any organizations and clubs.(Show years of membership and any offices held):
1)Name: Yrs.of Participation: Office Held, if any:
2)Name: Yrs. of Participation: Office Held, if any:
3)Name: Yrs.of Participation: Office Held, if any:
HONORS/AWARDS–Please list any honors/awards you have received:
1)
2)
3)
Are you a member of the National Honor Society? Yes No
If Yes, how many years?
COMMUNITY/OTHER ACTIVITIES:
No. of volunteer hours/month:
List organization/activities below:
1)
2)
3)
EMPLOYMENT HISTORY
Are you presently employed? Yes No
If Yes, how many hours per week? What type of work?
Present Employer: ______
Full-Time_____ Part-Time ____ Summer ______
Position Employment Dates
Hours per Week Type of Work
Will you have to provide part of the financing for your education? Yes No
If Yes, how do you plan to do this?
STUDENT AID INFORMATION
After completing the FAFSA (Free Application for Federal Student Aid) located at you will receive the SAR (Student Aid Report) that contains information about student aid for which you are eligible. Please submit the SAR (Student Aid Report) to us.
INITIATIVE
List three examples of times when you exhibited “initiative,”when you decided on your own that something needed to be done, you identified a solution, and you implemented the solution.Explain the situation and the outcome.
1)
2)
3)
_____ I do not have a family member who is a member of Assistance League of Montgomery County. (Put an “X” in the space provided if this is a true statement).
Assistance League of Montgomery County will not divulge any information provided on this form to any other person or entity without the applicant’s specific written consent.
SUBMISSION INSTRUCTIONS
- Deliver the scholarship application package to Assistance League of Montgomery County.
The scholarship package includes:
Completed and signed application form which includes two essays.
Letter of recommendation from the counselor, a high school teacher, or the principal, signed and sealed in a separate envelope.
Current official transcript, signed by the counselor.
All pages of the Student Aid Report (SAR).
- The Scholarship package may be delivered in the following ways:
It can be mailed to the following address:
Assistance League of Montgomery County
Attention: Scholarship Chairman
126 North San Jacinto
Conroe, TX 77301
- Must be postmarked on or before, Wednesday, March 21, 2018.
OR
It can be hand-delivered to Assistance League of Montgomery County Thrift Shop at the above address. The Thrift Shop hours are Tuesday-Saturday from 10:00 am to 3:00 pm.
- Must be delivered on or before Wednesday, March 21, 2018.
This application package must be postmarked or hand delivered to Assistance League of Montgomery County by Wednesday, March 21, 2018.
Applicant’s Signature: ______
Date: ______
ESSAYS– Click in the shaded area below, and begin typing. The spacing will automatically adjust and go to another page.
1)Write approximately 500 words that provides information about yourself that you feel will completely and accurately portray you:
a)Your background
b)Personal traits
c)Goals
d)Most meaningful achievements and how they relate to your field of study
e)Your future goals and why you are a good candidate to achieve this award
f)Also, include why it is important to Give Back to the Community
(Box Here)
2)Write a second essay of approximately 500 words in which you address from a financial standpoint:
a)What impact this scholarship would have on your education
b)State any special personal or family circumstances affecting your need for financial assistance
(Box Here)
Philanthropic Programs/Scholarship
2-Year/4-Year Scholarship Application
January 2018
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