Instructions for Filing This Application

MEMORY OF TOOTS GERSTAD

INSTRUCTIONS FOR FILING THIS APPLICATION

1. Applicant should complete pages 2, 3, and 4, dating and signing page 4 as indicated.

2. Applicant should have his/her parents or guardians complete the top portionof page 5 before submitting it to his /her high school guidance counselor. Applicant should allow 2 weeks time for the guidance counselor to review and submit his/her application and transcripts before the March 11, 2018 deadline.

3. The guidance counselor will sign and date page 5 verifying all the information on the application. The guidance counselor will mail the application and the students latest transcripts to: The First United Methodist Church,” I Love Music Scholarship” Committee 3717 West Main Street McHenry IL. 60050 no later than March 11, 2018.

4. Applicant should present page 6 and page 7 to two instructors or directors whohave personally worked with the student with his pursuit of his musical ability. These persons will complete part II and mail the signed form directly to The First United Methodist Church, “I Love Music Scholarship” Committee 3717 West Main Street McHenry IL 60050 or email to before March 11, 2018.

Additional Information

The scholarship you are applying for is made possible by the income from the “I

Love Music” Trust Fund in memory of Toots Gerstad held by the United Methodist Foundation of Northern Illinois Conference, Inc. It awards $7,500 for four consecutive years to an individual who is seeking a music major and is either an active member of the First United Methodist Church of McHenry or resides in High School District 156 McHenry County, IL. The scholarship will be paid directly to the college or university the student is enrolled in. The applicant must demonstrate a proficiency with a musical instrument or other vocal musical talent on March 25, 2018 at 11:15 a.m. as well as maintain a “C” average in his/her high school.

Toots loved all music and shared her talents faithfully at the First United Methodist Church. In memory of Toots the recipient of this award will be required to share their music every year at the First United Methodist Church in McHenry IL.

IN MEMORY OF TOOTS GERSTAD

NAME ______DATE ______

Last, First, Middle

HOME ADDRESS ______

Street, City, State, Zip

CELL PHONE NUMBER______-______-______

HIGH SCHOOL OR COLLEGE NOW ATTENDING______

DATE OF EXPECTED OR ACTUAL GRADUATION______SCHOOL ADDRESS ______

Street, City, State, Zip

G.P.A.______DATE OF BIRTH______EMAIL ADDRESS______

LIST YOUR ACCOMPLISHED MUSICAL INTERESTS (INCLUDE VOCAL)

INSTRUMENT #YEARS PLAYED #YEARS /LESSONS LAST INSTRUCTOR

______

______
______
______
______

LIST ANY SPECIAL RECOGNITION YOU HAVE RECEIVED

INSTRUMENT YEAR AWARDED AWARD EVENT

______

______
______
______
______
______

______

(PLEASE CONTINUE THIS LIST ON THE BACK IF MORE SPACE IS REQUIRED)

IN MEMORY OF TOOTS GERSTAD

LIST ALL PERFORMANCE IN THE LAST TWO YEARS

INSTRUMENT DATE EVENT LOCATION

______

______
______
______
______

(PLEASE CONTINUE THIS LIST ON THE BACK IF MORE SPACE IS REQUIRED)

LIST UNITED METHODIST CHURCH ACTIVITIES IF ANY: (INCLUDE CONFIRMATION)

______DATE______

LIST OTHER SCHOLARSHIP OR AID SOURCES TO WHICH YOU HAVE APPLIED AND/OR ACCEPTED. (PLEASE INDICATE THOSE ACCEPTED).

______

WHAT HAS BEEN YOUR WORK EXPERIENCE IN THE PAST TWO YEARS?

______

IN MEMORY OF TOOTS GERSTAD

LIST THE COLLEGES OR UNIVERSITIES YOU ARE APPLYING TO
______

______

WHAT ARE YOUR EDUCATIONAL AMBITIONS AND GOALS? ______

______

HOW DID YOU LEARN OF THE “I LOVE MUSIC SCHOLARSHIP”? ______

______

WHICH INSTRUCTORS (OR DIRECTORS) HAVE YOU ASKED TO COMPLETE A RECOMMENDATION FOR THIS APPLICATION?

______TITLE______TITLE______

WOULD YOU BE WILLING TO PERFORM A 2-3 MINUTE SONG AND ANSWER QUESTIONS AT 11:15 A.M ON MARCH 25, 2018? ______

______

IN MEMORY OF TOOTS GERSTAD

IN 150 WORDS OR LESS DESCRIBE YOUR AMBITIONS AND GOALS AFTER YOU’VE ACHIEVED YOUR MUSIC MAJOR.______

______

Student

SIGNED______DATE______

IN MEMORY OF TOOTS GERSTAD

PARENTS OR GUARDIAN FORM

PARENTS HOME PHONE#______

FATHER’S NAME______LIVING?______

OCCUPATION______PLACE OF EMPLOYMENT______

______CITY______

MOTHER’S NAME______LIVING?______

OCCUPATION______PLACE OF EMPLOYMENT______

______CITY______

NUMBER OF DEPENDENT CHILDREN IN THE FAMILY______

NUMBER OF CHILDREN IN COLLEGE IN THE FAMILY______

NUMBER OF CHILDREN IN HIGH SCHOOL IN THE FAMILY______

HAS THE APPLICANT ANY INDEPENDENT FINANCIAL RESOURCE OF HIS/HER OWN? ______

______

PARENTS OR GUARDIAN’S SIGNATURES______

GUIDANCE COUNSELOR’S SECTION

I VERIFY THE INFORMATION ON PAGES 2, 3, AND 4 TO BE CORRECT AND HAVE ENCLOSED THIS YEAR’S FALL TRANSCRIPTS OF THIS APPLICANT.

COUNSELORS SIGNATURE______

DATE______PRINT NAME______

APPLICATION DUE MARCH 11, 2018

BY 3:00 P.M.

IN MEMORY OF TOOTS GERSTAD

PART I: TO BE COMPLETED BY THE APPLICANT:

NAME OFAPPLICANT______

LAST, FIRST, MIDDLE

HOME ADDRESS______

STREET, CITY, STATE/ZIP

PART II: TO BE COMPLETED BY INSTRUCTOR OR DIRECTOR:

HOW LONG HAVE YOU KNOWN THE APPLICANT?______

HAS THIS APPLICANT BEEN TAUGHT UNDER YOUR DIRECTION?______FOR HOW LONG (DATES)______

YOU’RE ASSISTANCE IN DESCRIBING THE APPLICANTS PERSONAL QUALITIES, MUSICAL ABILITIES, DILIGENCE, INTEGRITY, MOTIVATION, LEADERSHIP, INFLUENCE ON OTHERS AND ABILITY IN PURSUING A MUSIC MAJOR WILL IS GREATLY APPRECIATED.

PLEASE MAIL OR EMAIL THIS RECOMMENDATION TO THE ADDRESS BELOW BY MARCH 11, 2018. ______

SIGNED______DATE______

NAME PRINTED______POSITION______

IN MEMORY OF TOOTS GERSTAD

PART I: TO BE COMPLETED BY THE APPLICANT:

NAME OF APPLICANT______

LAST, FIRST, MIDDLE

HOME ADDRESS______

STREET, CITY, STATE/ZIP

PART II: TO BE COMPLETED BY INSTRUCTOR OR DIRECTOR:

HOW LONG HAVE YOU KNOWN THE APPLICANT? ______

HAS THIS APPLICANT BEEN TAUGHT UNDER YOUR DIRECTION? ______IF SO FOR HOW LONG (DATES) ______

PLEASE MAIL OR EMAIL THIS RECOMMENDATION TO THE ADDRESS BELOW

BY MARCH 11, 2018. ______

SIGNED______DATE______

NAME PRINTED______POSITION______