Carmel High School
Lilly Endowment Community Scholarship
Student Application Checklist
Student Name ______E-mail Address______
Item #1 ______Completed Scholarship Application Form
Item #2 ______Four Essay Responses
Item #3 ______Two Letters of Recommendation
(recommenders may provide letters directly to the applicant in a sealed envelope OR send them directly to Mrs. Stephan ()
Item #4 ______CHS Transcript
Please answer the following essay questions and attach to the application. One essay response per page, please.
Essay Questions:
#1 Educational/Career Goals: In 500 words or less, please describe your educational and career goals. What steps have you taken and what do you plan to do to attain these goals?
#2 Significant Experience: In 500 words or less, evaluate a significant experience, achievement, risk or ethical dilemma and its impact on you. How will this experience and skills you have developed help prepare you to graduate from college despite potential barriers?
#3 Community Service: In 500 words or less, please describe how your commitment to community service has impacted your life, and describe how you see yourself continuing to give back to your community in five years.
#4 Financial Support: In 500 words or less, please describe, from a financial standpoint, what impact this scholarship would have on your education.
Please return this cover sheet with the required documents to
Mrs. Stephan in the Counseling Office no later than 3:30 p.m.
on Monday, August 15, 2016.
Carmel High School
Lilly Endowment Community Scholarship
Student Application
Contact Information
First Name:______Phone: ______
Middle Name: ______Alternate Phone: ______
Last Name: ______Email Address: ______
Address, City, State, Zip ______
Demographic Information
Gender:______Birth Date: ______
Birth Country: ______Birth State/Province: ______
Native Language?:______
Academic Information
Cumulative G.P.A.: ______
Diploma Type?: ____ Core 40 ____ Academic Honors ____ Technical Honors
Test Scores
ACT Composite Score: ______
SAT Total Score:______SAT Critical Reading Score: ______
SAT Math Score: ______SAT Writing Score: ______
College Information
College Name Choice College (1st, 2nd, 3rd) Field of Study
1. ______
2. ______
3. ______
Work Experience (you may attach a resume in lieu of completing this section)
Job Title Employer Hours Per Week Start Date End Date
______
______
______
Extracurricular Activities (you may attach a resume in lieu of completing this section)
Activity Type Total Hours Leadership? Dates of Participation
______
______
______
______
______
______
Honors and Awards (you may attach a resume in lieu of completing this section)
Awarding Organization Honor/Recognition Description Award Date
______
______
______
______
______
______
Recommendations
Please include the names and contact information for your two recommenders below:
Name Relationship Years Known Email
1. ______
2. ______