Kahuku Alumni Sponsors

KAHUKU ALUMNI ASSOCIATION – UTAH CHAPTER SCHOLARSHIP

KAHUKU ALUMNI ASSOCIATION

UTAH POLYNESIAN SCHOLARSHIP PROGRAM

Application Deadline: April 15, 2007

The Kahuku Alumni Association – Utah Chapter is proud to offer one (1) $1,000 scholarship to 2007 graduates of a Utahhigh school to encourage our Polynesian Students to continue studying at an accredited 2 year or 4 year institution or technical school. The scholarship will be awarded to one (1) Polynesian graduate of a UtahHigh Schoolfrom the class of 2007.

In order to assure that the most deserving Polynesian graduate receivesthe scholarship from the alumni association, the identityof and information provided about individual candidates will be kept confidential. Scholarship recipients will be announced in May 2007 - prior to high school graduation.

Eligibility Criteria:

Any Polynesian Student attending a UtahHigh School graduating in May / June 2007.
Polynesian Ancestry must be verified by Parents.
Students must enroll in college or trade school in Fall 2007.

Selection Criteria (Weighting):

Academics (40 Points Possible)
Student Activities (10 Points Possible)
Community Service – Involvement (10 Points Possible)
Special Awards and Honors - Academic &Athletic Achievements (10 Points Possible)
Personal Motivation and Eagerness to Learn (10 Points Possible)
Personal Commitment to Serve Utah’s Polynesian Community (10 Points Possible)
Letters of Recommendation (10 Points Possible)
Bonus Points for Students whose parent (s) or grandparent (s) graduated from KahukuHigh School (5 Points Possible)

Instructions to Applicants:

Complete this application and attach a copy of your high school transcript.
Ask two non-family members to fill out the Letters of Recommendation; at least one recommendation must be from a teacher, counselor or other member of your high school faculty.
Submit (must be post marked by April 15, 2007 if mailed) entire application to:

Kahuku Alumni Association – Utah Chapter

1821 North 1450 West

Layton, Utah 84041

Or E-Mail the application to

PART 1 - SCHOLARSHIP APPLICATION FORM

PERSONAL INFORMATION

Full Name of Applicant
CurrentHigh School
Date of Birth & Age
Place of Birth
Sex (Male or Female)
Polynesian Ancestry – Samoan, Tongan, Hawaiian, Maori, Tahitian, etc.
Social Security Number
Home Address, City, Zip
Mailing Address, City, Zip
Home Phone Number
Father’s Full Name
Mother’s Full Name
Guardian (if other than Parents)
Guardian’s Address
Guardian’s Phone Number
Number of Siblings living at home (include fist names)
Any other relevant information

DECLARATION

I hereby declare that I prepared this application and that the information provided is correct and complete. I am willing to be interviewed regarding this application. I also authorize the Kahuku Alumni Association – Utah Chapter to use my name and photograph for publicity purposes should I be granted a scholarship.

Applicant’s Signature:

Date:

I hereby declare that I have read this application and that the information provided is correct and complete. I also hereby declare that my son / daughter is of Polynesian Ancestry. I also agree to provide written verification of his / her ancestry if requested by the scholarship committee.

Guardian’s Signature:

Date:

PART 2 - CANDIDATE’S APPLICATION FORM

ACADEMIC ACHIEVEMENT INFORMATION

Full Name of Applicant
GPA (4 years in high school)
Advanced Placement classes or other special classes completed
Academic Awards Received
Membership in clubs, honor society, etc.
Any other relevant information

POSTHIGH SCHOOL PLANS

Name in the order of preference the top three post high school institutions you would like to attend.

School Name ( List in order of preference) / Application Pending / Accepted for Admission
1.
2.
3.

OTHER AID PROGRAMS

Have you applied or intend to apply for any other financial aid or scholarship programs? ( ) Yes ( ) No

If yes, please list them below:

Title / Name of Program / Description / Date Applied
1.
2.
3.
4.

PART 2 – CANDIDATE’S APPLICATION FORM

Full Name of Applicant

STUDENT ACTIVITIES / ATHLETICS AND LEADERSHIP POSITIONS

List student activities in which you have participated during grades 9 – 12. These include student government, sports – athletics, student service groups and any other relevant organization related to your high school. DO NOT include community or church activities in this section.

Student Activities / Athletics / Grade / Leadership Position / Accomplishments / Grade
9 / 10 / 11 / 12 / 9 / 10 / 11 / 12
Example: Student Council / x / x / President / x

Describe any other relevant information pertaining to your student activities / athletics and leadership positions (i.e. what you learned or gained from participating in student government or playing football, volleyball, playing in the band, etc.).

PART 2 - CANDIDATE’S APPLICATION FORM

Full Name of Applicant

COMMUNITY SERVICE & INVOLVEMENT

List community activities in which you have participated during grades 9 – 12. These include service organizations, boy scouts, women’s groups, and any other relevant organization related to your community. You may include community or church activities in this section.

Community Activities / Grade / Level of Involvement / Hours per Week
9 / 10 / 11 / 12 / 1 to 5 / 6 to 10 / 11 to 15 / 16 Plus
Example: Boy or Girl Scouts / x / Patrol Leader / x

Describe any other relevant information pertaining to your community activities and leadership positions (i.e. what you learned or gained from participating in boy scouts or volunteering at the hospital, etc.).

PART 2 - CANDIDATE’S APPLICATION FORM

Full Name of Applicant

SPECIAL RECOGNITION, AWARDS & HONORS

List special recognition, awards and honors received during grades 9 – 12. These include service organizations, boy scouts, women’s groups, and any other relevant organization related to your community. You may include community or church activities in this section.

Commendation / Award / Grade / Group or Activity
9 / 10 / 11 / 12
Example:All State – 1st Team / x / x / Women’s Basketball

PART 3 – SHORT ESSAY QUESTIONS

Please select ONE of the following essay questions and answer as completely as possible. Please use a separate piece of paper to write your essay and INCLUDE your NAME and the Question Number that you are responding to. Please limit your essay to one page. Your essay is important because it will be used to determine your score in 2 areas: (a) Personal Motivation & Eagerness to Learn, and (2) Personal Commitment to Serve the Polynesian Community here in Utah.

Question # 1: Imagine you have graduated from college and are currently pursuing a career in your selected field of endeavor. You are given the responsibility of creating some kind of community benefit program for Utah’s Polynesian Community that makes sense for your business or organization.

Describe your project and its purpose. How will this project benefit Utah’s Polynesian Community? How will it benefit your employer or organization? Do you think that community responsibility should be important for organizations in the 2000’s? As a Polynesian and graduate, what responsibilities do you have to the next generation and how would your program help meet those responsibilities?

Questions # 2: As a Utah high school graduate and member of the Polynesian community, you are about to enter a new phase of your life. Please describe any professional, educational and personal goals you have set and why you set those goals. Also, describe how you plan to accomplish those goals.

Now imagine that you have achieved those goals and now have the opportunity to give something back to Utah’s Polynesian community. Please describe how your chosen field of expertise can serve the community or meet specific needs. How will it benefit the community? What is the short term and long term impact on the community? What responsibilities do you have to the next generation of Polynesians and how would your field of expertise help meet those responsibilities?

PART 4 – CONFIDENTIAL LETTER OF RECOMMENDATION

Full Name of Applicant

REFERENCES

Please give the names and addresses of two (2) persons who have known you long enough to form a judgment of your personal qualities, achievements and academic abilities. Please have each person submit a Confidential Letter of Recommendation (see attached form) on your behalf by April 15, 2007. At lease one reference must be from a teacher, counselor or faculty member of your high school. Reference letters should be mailed directly or e-mailed to the address shown on the front page.

Name of Reference / Position / Title / Phone / E-Mail

PART 4 – CONFIDENTIAL LETTER OF RECOMMENDATION

DEADLINE: APRIL 15, 2007

Full Name of Applicant
Name of Reference / Position / Title / Phone / E-Mail

Instructions to Letter of Recommendation Writer: Please fill out this form and return to the Kahuku Alumni Association – Utah Chapter, 1821 North 1450 West, Layton, Utah or send the form via e-mail to Ben Au at .

This applicant is applying for a $1,000 scholarship to support continued education at an accredited 2–year or 4-year institution or technical school. The scholarship is designated for a candidate of Polynesian Ancestry who will graduate in May / June 2007 from a Utah high school.

Selection criteria include: (1) Academics, (2) Student Activities, (3) Community Service – Involvement, (4) Special Awards and Honors including academic and athletic achievements, (5) Personal motivation and eagerness to learn, and (6) Personal commitment to serve Utah’s Polynesian community.

Please describe your relationship with the applicant and your assessment of the applicant’s positive attributes and the applicant’s areas that need attention.

This statement is confidential and will not be released to the applicant or any other parties other than the Kahuku Alumni Association – Utah Chapter’s Scholarship Selection Committee.

Please attach the Letter of Recommendation to this form and submit to our selection committee as directed above.

PART 4 – CONFIDENTIAL LETTER OF RECOMMENDATION

DEADLINE: APRIL 15, 2007

Full Name of Applicant
Name of Reference / Position / Title / Phone / E-Mail

Please describe your relationship with the applicant and your assessment of the applicant’s positive attributes and the applicant’s areas that need attention.

This statement is confidential and will not be released to the applicant or any other parties other than the Kahuku Alumni Association – Utah Chapter’s Scholarship Selection Committee.

Please attach the Letter of Recommendation to this form and submit to our selection committee as directed above.