2015 PSFCU Rising Star Scholarship Application
Dear Member:
As part of our mission in helping members achieve financial success, the Credit Union realizes the need for a solid education. Dreams of a higher education are often hindered by financial difficulties. With these values in mind, the Polish and Slavic Federal Credit Union Scholarship Program was created.
The PSFCU Rising Star Scholarship Program is open to any PSFCU member (primary owner of the account; joint owners and children of owners do not qualify). The PSFCU Rising Star Scholarship Program is open to students who will continue studying full or part timetowards an undergraduate or graduate degree at an accredited institution in 2015/2016 (Current high-school students are not eligible). Scholarships will be awarded based on an extraordinary achievement in the field of academic, sport, music, art, science, leadership, or talent, etc. on the national or international level. PSFCU will evaluate the candidate’s application based on achievement, academic success, extracurricular involvement and commitment to the Polish/Slavic community. All decisions of the Scholarship Committee are considered final.
This year’s goal is to select 1 winner who will be awarded a $5,000 scholarship. The Committee will award one $5,000 scholarship. A member is limited to only one grant during the life of this program.
Please mail 1 copy of your completed, typed application and essay with a single copy of required documentation no later than April 30, 2015. Applications should be completed in English only. All Polish documents should have English translations attached. Awards will be issued directly to the scholarship recipients in the form of a check. Incomplete, late, faxed or e-mailed applications will not be accepted. Mailing instructions and a full listing of required documents are outlined on page 6 of this application.
LAST NAME, FIRST NAME:
Personal Information
Last Name, First Name, Initial Your Maiden Name/Other Last Names Used in the Past
Date Of Birth: / Place Of Birth:(Permanent) Address
/ City, State, Zip
(Alternate) Address
/ City, State, Zip
Phone () / E-Mail Address:
Cellular Phone ()
PSFCU Member #:
/ PSFCU Member Since (year):
Have you ever received PSFCU Scholarship? / If so, in what year?
What was your school level at the time:
High-School Undergraduate
Graduate
Your Status in the US:
Citizen/Permanent Resident
Student or other temporary visa
Other
LAST NAME, FIRST NAME:
Academic Information
Your Current Status as of spring semester 2015 (Check all that apply):Full Time Student Part Time Student
Undergraduate Graduate
Year in your current program: Length of your program: Your current/intended major:
List all Institutions attended since high-school:
School Name / Address
(City, State) / Dates attended
(MM/YY) include expected graduation dates / GPA / Degree
Earned
List your academic distinctions/honors/awards (up to 10) List, in order of importance, academic honors, awards, distinctions etc. received during the past 4 years (candidates who interrupted their schooling should list awards received while they were in school).
LAST NAME, FIRST NAME:
Extracurricular Involvement - Please fill in the following two tables. Lists should be in order of importance. Please enter each activity/achievement only once -- do not duplicate information in the tables. Please list activities from the last 4 years only. Only information from the tables will be considered by the Committee. Do NOT send any additional materials.
List membership in up to 8 organizations, professional associations, sport teams etc. Please note the duration and time intensity of your involvement and any offices held.Organization Name / Dates of involvement
(MM/YY-MM/YY) / Time commitment
(e.g. hrs/week and weeks/year) / Offices held
(brief description)
List your 5 most important extracurricular achievements and briefly describe them.
Achievement / Date / Description
LAST NAME, FIRST NAME:
List your 5 most important jobs (above 10 hours/week) or community service (above 50 hours/year) performed over the past 4 years.Name of firm/organization / Dates of involvement
(MM/YY-MM/YY) / Time commitment
(e.g. hrs/week and weeks/year) / Description
Which PSFCU sponsoring organization (Polish-Slavic Center, Polish Cultural Foundation in Clark, Polonia of Long Island, Inc. [former Polish Friends of Copiague], Polish Supplementary School Council of America, Inc., General Pulaski Memorial Parade Committee, Alliance of Polish Clubs in the USA, Kosciuszko Foundation, Polish Highlanders Alliance of North America) are you a member of, and what is the extent of your involvement?
Essay
1) Mandatory. Answer the following essay question (under 3000 words) on an attached sheet of paper with your name. Please describe in detail the achievement on which you have based your application, including why in your opinion you deserve to win this award. Include things such as language study and relevant academic interests, involvement in Polish/Slavic organizations (example: Scouts, Church, student clubs, music or folk dance groups) as well as community involvement (example: charity work, contributions to Polish/Slavic media and culture, help with Polish/Slavic institutions and events). How do you plan to continue your involvement in the future?LAST NAME, FIRST NAME:
Supporting Materials & Mailing Instructions
Along with this application please submit the following:1) Official transcripts from ALL academic institutions attended since high-school. Current college freshmen must send current college transcript AND a copy of their high-school transcript.
2) Letter of reference, with recommendation written by a professor or mentor in support of the application. Please note that recommendations from family members are not permitted. Please indicate below the names and contact numbers of the people whom you asked to write your letters.
3) If changing schools by September 2015 send a copy of your acceptance letter from the school that you plan to enroll in.
4) Applicants should utilize tables on the application form. Additional materials in support of the candidate, constituting proof of the achievement, should be submitted along with the application.
5) Applicants must be PSFCU members at the time of application.
6) Please mail completed application and essay, together with a single copy of the supporting documentation to:
PSFCU Scholarship Committee
9 Law Drive
Fairfield, NJ 07004
IMPORTANT! Faxed, e-mailed and hand delivered (left in PSFCU branches) applications will not be considered.
Affidavit of Eligibility and Release
I submit this Affidavit with the understanding that it will be relied upon to confirm my eligibility to be awarded a prize in the Scholarship Program:1) I understand that I am solely responsible for all applicable taxes on my Scholarship which may be awarded to me.
2) For valuable consideration, I give PSFCU and their agents and assignees, full permission and authority to use, publish and display my name, photograph or likeness and or any biographical data I may provide and any statement that I may make concerning this Scholarship Program.
______
Date Signature of Scholarship Applicant
LAST NAME, FIRST NAME:
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