Green Bay Area P.E.O. Reciprocity Scholarship

Application Form

Scholarship Range up to $7,000 – Available for 2016-17 School Year – Due April 22

CRITERIA

  1. Applicant must be female, a Brown County resident and a US/Canadian citizen or legal resident.
  2. Applicant must have at least 24 consecutive months as a non-student sometime in her adult life and be within 24 months of completing her educational goal.
  3. Applicant must NOT be enrolled in a doctoral degree program.
  4. Applicant must demonstrate financial need through FAFSA (see Page 2).
  5. Applicant must attach a Personal Statement (see page 2).

This scholarship requires an annual application.

All applications will be evaluated on the basis of information requested on the form.

Fill out this form completely so that the committee can understand your situation.

Type or print clearly.

Complete both pages of this form and mail it to the address listed on Page 2.

PERSONAL DATA

Name: ______Phone: ______Date of Birth: ______

Address: ______City: ______Zip: ______County ______

Student ID #: ______Social Security Number (last 4 digits) ______

Marital Status ______Number of Dependents at Home: ______

Email address ______

** Use an email address you check regularly. You will be notified of your status and/or acceptance via email. **

EDUCATIONAL INFORMATION

High School ______Location ______

H.S. Graduation or G.E.D. Date ______

Past College, Technical or other Educational Experience______

______

Are you currently enrolled? ______Where? ______

What institution do you plan to attend Fall 2016? ­­­­­­­­­­­­­­ ______Degree sought? ______

Number of credits planned for Fall 2016 ______Expected Graduation Date ______

WORK EXPERIENCE

Present ______Hours ______

Past Two Years ______

Anticipated employment for coming academic year ______

FINANCIAL INFORMATION REQUIREMENT

All applicants must complete and file the Free Application For Student Aid (FAFSA).

A Student Aid Report (SAR) will be sent to you from the Department of Education after you file.

**A copy of all pages of the SAR must be received with this application.**

EXPENSES PER 2016-17 ACADEMIC YEAR

Books*$______

Tuition*$______

Total Education Expenses*$______

*Estimate if necessary. This section must be completed.

PERSONAL STATEMENT

On a separate sheet of paper, write a statement addressing each of the three topics

listed below.This will be a major factor in the committee's decision process.

Please type or use a word processor.

  1. Why you are applying for a scholarship
  2. Your educational and career goals
  3. Why your education was interrupted

We encourage you to add letters of reference from employers or school representatives (advisers, etc.). However, your application will not be rejected if you cannot provide these.

I affirm that all the information in this application is correct to the best of my knowledge.

Signature ______Date______

** Your complete application, including Student Aid Report,must be postmarked by

April 22, 2016, and sent to Janet Roberts, 105 W Mission Road, Green Bay, WI 54301 **

We reserve the right to withdraw scholarship if disqualifying information is revealed following our initial decision.

The P.E.O. Sisterhood is a philanthropic, educational organization that promotes education for women,

including Cottey College, a four-year college for women in Nevada, Mo., and loan and scholarship programs for undergraduate and graduate-level students. Visit to learn more.