2010 Fcclv Scholarship Application

2016FCCLV SCHOLARSHIP

Application deadline - March 12, 2016

The Florida Council of Citizens with Low Vision scholarship is awarded to an outstanding student who is enrolled in academic, professional or technical training beyond the high school level. The $1000.00 award is given for either academic excellence or to an eligible applicant who is enrolled in a course of study, which will increase advancement potential in his/her chosen field. This scholarship may be awarded to a full or part-time student; however, special preference will be given to applicants who have low vision since this is an organization for persons with low vision.
ELIGIBILITY REQUIREMENTS:

Applicant must be a resident of the State of Florida; however, their college or university doesn't necessarily have to be in Florida.
Applicant must have a high school diploma, a high school-equivalency diploma, or be a graduate from an approved homeschool program. (Current high school seniors may also apply.)
Applicant must either be enrolled or accepted for enrollment in a college, university or trade school.
Applicant must have at least a 3.0 grade point average.

All applications will be reviewed by the Florida Council of Citizens with Low Vision Selection Committee. The recipient of this scholarship will be notified before the Florida Council of the Blind’s State Convention May 13-15, 2016.

FCCLV SCHOLARSHIP APPLICATION

Application deadline is March 12, 2016

Please complete this application and email it and any supporting documents to by March 12, 2016.

Should email be unavailable to you, you may mail your application package to:

Florida Council of Citizens with Low Vision

C/O Leslie Spoone

3924 Lake Mirage Blvd.

Orlando, FL 32817

If you have any questions, contact Leslie Spoone at

407-678-4163 or

I. PERSONAL DATA:
Name: ______
Address: ______
City/State/Zip: ______
Summer address: (if different from above)
Address: ______
City/State/Zip: ______
Daytime Phone: (_____) ______
Evening Phone: (_____) ______

E-mail Address: ______
Male: ____ Female: _____ Date of Birth: ______

II. VISUAL STATUS:
Check all the methods you use for reading:
(_) Braille (_) Recordings (_) Large print (_) Regular print (_) Live reader

III. EDUCATIONAL BACKGROUND:
A) Name and address of school in which you are currently enrolled or last attended:
Name: ______
Address: ______
City/State/Zip: ______
Grade point average (based on 4.0 scale): ______
Major:______
Number of hours: ______
Degree/Certificate sought: ______
Date degree expected: ______

B) School you plan to attend (if different from above)
Name: ______
Address: ______
City/State/Zip: ______
Major: ______
Number of hours: ______
Degree/Certificate sought: ______

Date degree expected: ______

C) List any additional secondary or post-secondary schools which you have attended:

Name of school: ______
City/State/Zip: ______

Grade point average (based on 4.0 scale):Dates attended: From: To: __

IV. NARRITIVE STATEMENT:

Please provide a narrative statement regarding your vocational objectives and the outlook for employment in your chosen field. Include an explanationof why you need this scholarship and how you will make best use of the money.

V. AWARDS AND SCHOLARSHIPS:

Please attach a list of any awards or scholarships you have received or that are pending.

VI. WORK EXPERIENCE:
Please attach a list of any full-time or part-time work experience you may have. Indicate whether this is summer employment or during the school year.
V. EXTRACURRICULAR ACTIVITIES:
Please attach a list of any major outside activities (school, church, community, sports, organizations, recreation, etc.). Indicate extent to which you have acted in a leadership role.

VI. TWO LETTERS OF RECOMMENDATION

Please provide two letters of recommendation.
VII. OFFICIAL TRANSCRIPT

Please have a transcript emailed from your most currently attended school. An “unofficial” transcript is acceptable for review purposes, but an official transcript will be required of the scholarship winner before funds are awarded.

VIII. CERTIFICATION OF VISUAL STATUS
To be completed by a physician or agency executive serving people with low or no vision.

For purposes of the Scholarship Application, FCCLV considers a person to be low vision if the best corrected vision in the better eye is not greater than 20/70, but is better than light perception or light projection or whose visual fields have a maximum diameter of no greater than 30 degrees.
This is to certify that the person named on this scholarship application is known to me and has a low vision condition.
Cause of visual impairment: ______
Visual Acuity: Right eye: ___ Left eye: ____Field:____

Name: ______
Title: ______
Address: ______
City/State/Zip: ______

Telephone number: ______

Signature: ______
Date: ______