Assistance League of Montgomery County

Assistance League of Montgomery County

Assistance League of Montgomery County

Texas Public College/University Scholarship Application


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.



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:



Mother’s/Guardian’s Name:


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?


College or University you plan to attend:

Have you been accepted? Yes No


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:




Are you a member of the National Honor Society? Yes No

If Yes, how many years?


No. of volunteer hours/month:

List organization/activities below:





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?


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.


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.




_____ 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.


  1. 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).

  1. 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.


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


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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