State Farm Insurance Dan Christensen

State Farm Insurance – Dan Christensen

Ketchikan HS Student Educational Scholarship

Eligibility Guidelines, Application Criteria and Instructions

Scholarships of $1,000 each are available to be awarded for the 2013 – 2014 academic year for aKetchikan High School or Revilla High School graduating seniors attending any University of Alaska campus.

Required Submissions:

1.Completed application.

2.Essay. This essay is very important. A subjective review of your essay is a significant part of the evaluation.

3.Two brief letters of recommendation from responsible persons not related to the applicant. Two letters of reference are required, preferably from a previous teacher(s), employer(s), minister(s), or other professional person(s) not related to the applicant.

4.Copy of high school transcript.

5.An activities list. The activities list should detail the activities you participated in, especially those that provided a service to the community and include your role and amount of time you were involved.

Deadline: Completed application must be postmarked by April 29, 2013. Applications must be dated signed by the applicant. Incompleteor un-typed applications will not be considered.

SEND COMPLETED APPLICATION TO:

UAS Ketchikan, ATTN: Gail Klein

2600 7th Ave

Ketchikan, AK99901

State Farm Insurance – Dan Christensen EducationalScholarship

KetchikanHigh SchoolScholarship Application

Biographical Information

Name: ______SSN: ______

Other Previous Names: ______

Mailing Address: ______

Telephone: (home)______(work, message, cell) ______

Financial Information

Funds AvailableEstimated Annual Expenses

Annual Taxable Personal Income ______Tuition & Fees ______

Parental Support ______Books /School Supplies ______

Scholarships/Grants ______Transportation ______

Loans ______Housing/Food ______

Savings/Other ______Other ______

Total Income: ______Total Expenses: ______

Educational Information/References

College attending: ______

Have you been accepted or are you currently enrolled?  Yes  No Date Classes Start: ______

Current Cumulative Grade Point Average (CGPA): ______

Scholarship Essay

Provide an example ofa time in your life when you had to work hard to accomplish something. Tell us how you overcame that hardship and what you learned from the experience. Your essay should be at least 500 words.

Agreement

I understand that if this award may be taxable in the United States; and that this application must be postmarked no later than April 29, 2013. I certify that the information in this application is complete and accurate to the best of my knowledge, and I will notify the Scholarship Committee if there is any change.

Date:______Sign Here:______

Letter of Recommendation

Applicant’s name: ______

This student is applying for a scholarship through State Farm Insurance. Please describe his or her strengths in dealing with adversity. Comment on any other characteristics which you feel are important for the scholarship selection committee to consider. Support your statements with reference to your personal experience with the applicant. You may attach a letter to this form. Thank you for your assistance in this important task.

Please rate the tendency of this student to work hard in accomplishing his or her goals. Your check mark below will assist the scholarship selection committee in rating this student when compared to other applicants:

 Below Average  Average  Above Average  Outstanding  Exceptional

(lowest 40%) (middle 20%) (next 15%) (next 15%) (highest 10%)

Name: ______

Position or Title: ______Relationship to Applicant: ______

Sign Here: ______Date: ______

Letters of reference should be returned to the student.

The Scholarship Application deadline is Monday, April 29, 2013.

Letter of Recommendation