Universal Scholarship Application

UNIVERSAL SCHOLARSHIP APPLICATION

THIS FORM IS TO BE USED FOR THE FOLLOWING SCHOLARSHIPS:

SONS OF AMERICAN LEGION-SQUADRON #189 (see p. 5)

MILLER'S MERRY MANOR, CINDY HERMAN MEMORIAL SCHOLARSHIP (nursing)

MICHAEL CHARLES ALBERT SCHOLARSHIP FUND

WILLIAM E. NICHOLS CREATIVE ARTS SCHOLARSHIP (art related)

NORTH LIBERTY PTA SCHOLARSHIP

WILMA MARTIN SCHOLARSHIP (Polk Twp. residents; education major)

NORTH LIBERTY CHAMBER OF COMMERCE, CHARLES "CUB" BARE SCHOLARSHIP(essay-see p.5)

HARRY R. GANSER MEMORIAL SCHOLARSHIP (essay- see p. 6)

WALKERTON AREA CHAMBER OF COMMERCE SCHOLARSHIP (essay-see p. 7)

MATTHEW JAMES MORRIS SCHOLARSHIP (gpa = or > 3.0; essay - see p. 8)

BRYAN VERKLER MEMORIAL SCHOLARSHIP (law enforcement majors; VincennesUniversity)

KAYLA M. TRAVERSA MEMORIAL SCHOLARSHIP (see p. 9)

CLARK FAMILY MEMORIAL SCHOLARSHIP (see p. 10)

JAMES “JIMBO” HASKINS MEMORIAL SCHOLARSHIP (see p. 11)

WES PTA Scholarship (Former WES student – essay – p. 12)

North Liberty Zeta Pi Tri Kappa Scholarship (essay – p. 12)

WALKERTON AREA HISTORICAL SOCIETY ~ Joseph L. Lowry Memorial Scholarship (essay – p. 13)

HAROLD C UREY MIDDLE SCHOOL SCHOLARSHIP (essay – p. 14)

ALVIN C. BOISE MEMORIAL SCHOLARSHIP (essay – p. 15)

ALL DEADLINES: APRIL 13, 2015

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PLEASE TYPE

NAME

LASTFIRSTMIDDLE

HOME ADDRESS

STREET OR ROUTE CITY STATE ZIP

TELEPHONE DATE OF BIRTH

FATHEROCCUPATIONEMPLOYER

MOTHEROCCUPATIONEMPLOYER

GUARDIAN/STEP PARENTOCCUPATIONEMPLOYER

NUMBER OF BROTHERS & SISTERS LIVING AT HOME?I IN COLLEGE

SCHOOLS WHERE YOU HAVE APPLIED?CHECK IF YOU HAVE BEEN ACCEPTED

1)

2.)

3.)

WHAT COLLEGE MAJOR DO YOU PLAN TO PURSUE?

ANTICIPATED LENGTH OF PROGRAM OF STUDY?

PERSONAL DATA

DESCRIBE YOUR WORK EXPERIENCE DURING THE PAST FOUR YEARS. INDICATE DATES OF EMPLOYMENT IN EACH JOB AND APPROXIMATE NUMBER OF HOURS WORKED IN EACH WEEK.

EMPLOYER / POSITION / DATE FROM / DATE TO / HRS PER WK

LIST ALL SCHOOL ACTIVITIES IN WHICH YOU HAVE PARTICIPATED DURING THE PAST FOUR YEARS (e.g. student council, class board, music, athletics, etc.). LIST ALL COMMUNITY VOLUNTEER WORK IN WHICH YOU HAVE PARTICIPATED DURING THE PAST FOUR YEARS (e.g. church work, community organization service, 4-H, etc.) INDICATE ALL SPECIAL AWARDS OR HONORS.

ACTIVITY / SPECIAL AWARDS OR HONORS / # OF YEARS / ACTIVITY / SPECIAL AWARDS OR HONORS / # OF
YEARS

**ARE YOU A RESIDENT OF POLKTOWNSHIP?

PLEASE COMPOSE A STATEMENT OF YOUR PLANS AS THEY RELATE TO YOUR EDUCATION AND CAREER OBJECTIVES AND FUTURE GOALS. THIS ESSAY SHOULD BE APPROXIMATELY 100 WORDS IN LENGTH.

PLEASE REPORT ANY UNUSUAL FAMILY OR PERSONAL CIRCUMSTANCES YOU FEEL WARRANT ATTENTION.

OTHER AWARDS

PLEASE LIST BELOW THE NAME AND AMOUNT OF ANY GRANTS OR SCHOLARSHIPS THAT YOU HAVE BEEN AWARDED FOR THE COMING SCHOOL YEAR.

NAME OF SCHOLARSHIP OR AWARD / AMOUNT

WHAT DO YOU ANTICIPATE YOUR EXPENSES TO BE FOR A FULL YEAR AT SCHOOL?

HOW WILL YOU FINANCE YOUR COSTS THIS YEAR?

HOW MUCH HAVE YOU SAVED TOWARD YOUR EDUCATION?

DO YOU PLAN ON BEING EMPLOYED DURING COLLEGE/VOCATIONAL SCHOOL?

PLEASE INCLUDE THE FOLLOWING:

1. A GRADE TRANSCRIPT

1. A GUIDANCE COUNSELOR INFORMATION SHEET (ATTACHED)

1. TWO LETTERS OF RECOMMENTDATION. (TEACHERS, COUNSELORS, ADMINISTRATORS, MINISTERS, AND COMMUNITY MEMBERS ARE ACCEPTABLE)

1. A PHOTO, IF POSSIBLE

1. SPECIAL CRITERIA FOR CERTAIN SCHOLARSHIPS (SEE P. 5 - 11)

PHOTO

COLLEGE OR VOCATIONAL SCHOLARSHIP

GUIDANCE COUNSELOR REPORT

TO BE FILLED OUT BY THE JOHN GLENN HIGH SCHOOL COUNSELOR

LAST NAMEFIRST NAMEMIDDLE INITIAL

1. HOW LONG HAS THE APPLICANT ATTENDED YOUR SCHOOL?
2. IN WHAT FIELDS HAS THE APPLICANT DONE HIS/HER BEST WORK?

ART MATHEMATICS

BUSINESS EDUCATION MUSIC

PHYSICAL EDUCATION/ HEALTH

ENGLISH

FOREIGN LANGUAGE SCIENCE

INDUSTRIAL TECHNOLOGY SOCIAL STUDIES

INTERDISCIPLINARYAGRICULTURE

EDUCATION

HOME ECONOMICS

3. NUMBER IN CLASS: APPLICANTS CLASS RANK:

4. SAT/ACT SCORES: CRIT. READMATH Writing

Skills

1. HAS THE APPLICANT BEEN SUBJECT TO DISCIPLINARY OR ACADEMIC CENSURE DURING

HIS/HER HIGH SCHOOL STAY FOR DEFECTIVE SCHOLARSHIP OR MISCONDUCT?

DATE:COUNSELOR

ADDITIONAL CRITERIA

**IF APPLYING FOR THE SONS OF THE AMERICAN LEGION PLEASE ANSWER THE FOLLOWING QUESTION:

"DO YOU OR ANY OF YOUR RELATIVES BELONG TO THE SONS OF THE AMERICAN LEGION, THE AMERICAN LEGION, OR THE LEGION AUXILIARY?"

PLEASE LIST NAME, RELATIONSHIP, AND ORGANIZATION.

**IF APPLYING FOR THE CHARLES "CUB" BARE SCHOLARSHIP:

PLEASE INCLUDE AN ESSAY OF 250 WORDS OR MORE ON THE FOLLOWING TOPIC (YOU MAY ATTACH AN ADDITIONAL SHEET.)

"HOW PERSONAL INVOLVEMENT IMPROVES MY LOCAL COMMUNITY."

HARRY R. GANSER MEMORIAL SCHOLARSHIP

ESSAY: Your essay for this scholarship should address three areas. Outline your personal, educational, and career goals. Describe yourself as a leader and what leadership means to you. Finally, discuss the importance of friendship and what friendship means to you. Your essay should not exceed 500 words. Please type or print neatly in ink in the space provided below or attach an additional sheet.

Walkerton Area Chamber of Commerce Scholarship

The Walkerton Area Chamber of Commerce has a strong belief in community involvement. With that in mind, please submit an essay of 250 words or more on the following topic:

"How does my present personal involvement affect my community and how will my future personal involvement in my community affect it, as well?"

MATTHEW JAMES MORRIS SCHOLARSHIP

The Matthew James Morris Scholarship was created to honor Matthew’s dream of being the best he could be by completing a college education. The criteria for this scholarship was determined by Matthew’s view of life and the beliefs he exemplified. Matthew was a very courageous young man who was not afraid to try anything and gave everything of himself. He has a golden heart and a sense of integrity that was admired by his peers and adults alike. He was a very intelligent, but humble, young man. He was not one to judge others and viewed everyone as an equal. His perseverance stood out because he was determined to better himself, however, not at the expense of others. Matthew was raised with a strong conviction of values and morals which were instilled in him by this family. These helped to shape him into a gifted, level headed, spirited young man whose smile will forever be etched in our memories.

Criteria: JohnGlennHigh School Senior

GPA 3.0 or above

Essay: 500 words – (typed, double-spaced)

Explain what Integrity, Courage, and Perseverance mean to you and how you exemplify them in your life.

KAYLA M. TRAVERSA MEMORIAL SCHOLARSHIP

GPA of 2.0 higher

Must be involved in a club, sport, or extracurricular activity.

Please answer the following essay questions. (typed)

1. What have you gained from your experiences here at John Glenn that can help you with your

future plans?

2. Where do you see yourself in ten years?

CLARK FAMILY MEMORIAL SCHOLARSHIP

The Walkerton Volunteer Fire Department prides itself on protecting and serving our community. Our members are family, as well as the citizens we serve.

The Clark Family Scholarship was created to honor Keith, Alice, and Kelsey

and their role in our community.

Essay: 500 words or less

Describe your past and present community involvement. Explain how you plan to continue community involvement in the future. List and explain some goals after your college education.

JAMES “JIMBO” HASKINS MEMORIAL SCHOLARSHIP

In at least 300 words, describe what leadership, friendship,

and community involvement mean to you.

WES PTA SCHOLARSHIP ESSAY

In 500 words or less describe who or what at WES has influenced your life and/or helped you decide your career path.

NORTH LIBERTY ZETA PI TRI KAPPA - ESSAY

Please attach a short autobiography (100 words) to tell a little about your family, school and work history. Include your community/charity involvement. Then add a statement of your ambitions and goals.

(You may type your essay in the box below or attach an additional sheet.)

WALKERTON AREA HISTORICAL SOCIETY

JOSEPH L. LOWRY MEMORIAL SCHOLARSHIP

Joseph “Joe” L. Lowry was born and raised in the Walkerton area. He taught in South Bend and North Liberty schools for 38 years. He served on the John Glenn School Corporation Board of Trustees from 2002 until his death in 2010. He also contributed to the success of the John Glenn Building Trades program as an electrical instructor.

Applicants must pursue further education in one of the following occupational fields:

building trades/construction, plumbing, electrical, heating/air conditioning,

or automotive/diesel/farm mechanics.

Answer the following questions in essay form of 500 words or less:

*What area of expertise are you pursuing as you further your education?

*What classes have you taken, skills have you acquired, or life situations have you experienced while attending JohnGlennHigh School, which will benefit your future life goals?

*Describe a project you have planned or completed that demonstrates your interest or skills as related to your life goals.

HaroldC.UreyMiddle School Scholarship

Candidates must:

a)successfully complete 8th grade at UreyMiddle School

b)have a minimum GPA of 2.500 after 7 high school semesters

c)have been involved in 1 or more extra or co-curricular activities during their career at UreyMiddle School

Please list the extra or co-curricular activity/activities you were involved in while a student at UreyMiddle School:

Please address the following statement in no more than 250 words:

Reflect on 1 weakness that you have worked on since leaving middle school:

ALVIN C. BOISE MEMORIAL SCHOLARSHIP

College or Vocational

1958 - 1964 Agriculture Teacher-TynerHigh School

1964 - 1967 Guidance DirectorTynerHigh School

1967 - 1970 Guidance Director-JohnGlennHigh School

1970 - 1972 Principal-UreyMiddle School

1972 - 1978 Principal-JohnGlennHigh School

1978 - 1982 Guidance Director-JohnGlennHigh School

Write an essay about a teacher that has influenced you and how they have impacted your decision to pursue your future career. Include how you feel your future education will allow you to impact others in a positive way. Essay should not exceed 500 words.

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