NATHAN ALTMAN SCHOLARSHIP FOR CREATIVE WRITING
Administered by the Fayetteville Public Education Foundation
THIS APPLICATION IS FOR STUDENTS ENROLLED ATFAYETTEVILLEHIGH SCHOOL. Applicants must complete all items in each section and return form with attachments to Ms. Anne Butt or Ms. Holly Johnson by Thursday, March 8, 2012. You must attach a creativewritingsample,current transcript covering the last seven academic semesters, two photographs of yourself, and two letters of recommendation, which may be sent to Ms. Butt or Ms. Johnson under separate cover or attached to this application.
Applications should be returned to:
Holly Johnson, Executive Director ORAnne Butt
Fayetteville Public Education Foundation FHS College/Career Room
PO Box 571
Fayetteville, AR72702
Date Due:March 8, 2012
PERSONAL INFORMATION
Name: ______
Address: ______
Phone: Home______Cell______SS# (optional)______
Parents Name(s): ______
Mothers Occupation: ______
Fathers Occupation: ______
Siblings and ages: ______
______
EDUCATION DATA
Grade Point Average______ACT Score ______SAT Score ______
Awards or Activities Associated with Creative Writing______
______
List of School clubs or organizations (9th-12th)______
______
Extra-curricular/out of school organizations______
______
Job/work experience______
______
PLANS
Write a brief description of your plans following graduation from high school. Include the name of the college, its location, and interest in a particular course of study, including career ideas. Include any plans that you have for continuing to write creatively in your future. (Limit 250 words or less) ______
______
______
______
ATTACHMENTS
A. Essay attached as a current or previous sample for critique by the scholarship committee
(If you are applying for more than one FPEF writing award, please submit a different essay with each application.)
B. List two personal references other than family members (at least one must be a high school
teacher). Attach letters of recommendation from each one, or request they be sent under
separate cover.
Name Address Phone No. Relationship Years Known
- ______
- ______
C. Please attach a photograph made during the last year.
D. A transcript covering your last seven semesters
CERTIFICATION
My signature below certifies that I am currently enrolled in FayettevilleHigh School, I have completed the requirements for graduation. My signature further certifies that all information and statements provided by me on this application are true and correct to the best of my knowledge. In addition, I authorize FayettevilleHigh School to release any information included in this application to the Fayetteville Public Education Foundation.
Signature______Date:______
DATE DUE MARCH 8, 2012
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