Local Scholarship Application

Due to the Excelsior Springs High School Counseling office by March 15, 2017

I would like this application to be used for consideration for the following scholarships:

American Legion – general academic scholarship

American Legion Auxiliary -general academic scholarship – must rank in upper half of graduating class

Anderson-Taylor Memorial – must enroll in a 4-year college/university in MO, financial need strongly considered (*pending donor approval of new local application)

Bonnie Casto Memorial – general academic with emphasis on activities

Clay Lodge #207 Masonic – general academic

Diane McCullough Memorial –general academic

Excelsior Springs Business Women of Missouri – for female seniors, 2.5 or higher GPA

Excelsior Springs Chamber of Commerce – general academic

ESSD Custodial Department – general academic

Excelsior Springs Area Cultural Guild – must be planning to major in the arts and also complete a demonstration of your art/craft. See a counselor for more information.

Excelsior Springs Quarterback Club – general academic – must also provide a list of Quarterback Club activities that you have participated in or helped with.

Excelsior Springs Quarterback Club Visual Arts – must be majoring in visual art or design and include a photo example of your work

Excelsior Springs Rotary Club – general academic

Gary Kennedy Memorial – for future teachers – must also submit an essay on why you want to be a teacher

Gregg Williams Foundation – general academic

Martha Jarman Memorial – for students going into a healthcare career

Mary Denton Lamb Memorial – for future K-2 or reading teachers, 3.0 or higher cumulative GPA, must have elementary tutoring experience and a letter from the elementary teacher for whom you tutored and must enroll at a MO college/university

Michael Raybourn Memorial – general academic with emphasis on activities

Optimist Club Wendell Clark Memorial – general academic

Ray Reynolds Memorial – must be an ESHS wrestler

Student Council – must be a member of ESHS Student Council

Terri Garbison Memorial – general academic

Local Scholarship Application

Please turn in to the ESHS Counseling Office by March 15, 2017.

Please paper clip attachments. Do not staple.

General Information

Name:

Address:

City/State/Zip Code:

Phone Number:

Parent/Guardian Name(s):

Parent/Guardian Phone Number(s):

Is either parent a veteran? If so, which parent(s)?

Do you/did you have a grandparent who is/was a veteran?

How many children are there in the household under the age of 18?

How many children from the household will be attending college in the next school year?

Do you (the student) have a job? Yes No

If yes, what is the name of your employer?

If yes, what is the phone number of your employer?

Academic Information

What is your cumulative GPA?

What is your high school rank? out of

What is your ACT Composite score?

Anticipated college major:

Anticipated career:

Where will you attend college directly after high school?

Have you applied to and been admitted to this college/university?

Have you received scholarships or grants to attend this college/university? If so, in what amounts?

What is your approximate amount of unmet financial need to attend this college/university?

Will you live at home while attending college or in a dorm or apartment?

Extra-Curricular Activities & Awards - Please list your participation in school, community, church and service organizations over the last four years. Please indicate the year(s) you were involved in each activity and any offices held, honors and awards received. You may choose to copy and paste a student resume here if the same information is provided.

9th Grade -

10th Grade -

11th Grade -

12th Grade -

Community Service - Have you performed any community service not listed above? If so, please list the details of this experience. (Where? How many hours? Dates of service? Etc.)

Essay Questions

  • Please provide a short typed essay (300-500 words) about your career goals and future plans, including why you are pursuing the career you have selected.
  • Please provide a short typed essay (300-500 words) about why you should be selected as a scholarship recipient. Please include any challenges you may have faced or significant contributions to your school/community.

Letters of Recommendation

  • Please provide two typed letters of recommendation, one of which should be from a teacher and the other from an employer, coach, club sponsor, etc. Letters must not be from a person related to you.

Authorization of Release of Information

By signing below, we authorize that the information provided on this application is correct and truthful. We authorize Excelsior Springs High School to release a student transcript to organizations outside of the high school for the purpose of scholarship consideration.

Student Signature Parent Signature

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