SIMPSON MEMORIAL SCHOLARSHIP

Mrs. J. Lupton Simpson established a Memorial Scholarship Fund to provide financial aid to students who will attend college. The number and amount of the scholarships will be determined upon the market value of the scholarship fund assets. These scholarships will be awarded on a one-time only basis.

To be eligible for this scholarship a student must:

1.  be a graduate of Loudoun County High School or Loudoun Valley High School,

2.  have attended a Loudoun County public school and been a resident of Loudoun for at least two years prior to graduation,

3.  be accepted in a freshman class of a fully accredited college or university,

4.  have shown high scholastic achievement in high school, include high school transcript,

5.  have demonstrated high standards of character and citizenship, and

6.  have demonstrated a need for financial aid to pursue a post- secondary education, include a copy of FAFSA or SAR.

7.  not be a member of the immediate family of any full time employee of the Trustee or any member of the Selection Committee.

Students who wish to be considered for the Simpson Memorial Scholarship must complete and return the attached application form to their School Counseling Office by April 1, 2016.


Simpson Memorial Scholarship — Number of Scholarships to be Determined by the Trustee Based upon the Market Value of the Scholarship Fund Assets

Criteria: High school seniors attending Loudoun County or Loudoun Valley High School

Have attended a Loudoun County public school for at least two (2) years prior to graduation

Demonstrate he/she needs such financial aid to pursue a post-secondary education and include a copy of FAFSA or SAR

Shown high scholastic achievement in high school, include high school transcript

Demonstrated high standards of character and citizenship

Cannot be a member of the immediate family of any full-time employee of the

Trustee or any member of the selection committee

Selection: Recipients will be chosen by a Scholarship Selection Committee based on academic achievement, financial need and potential to succeed in the student’s chosen educational field.

Deadline: April 1, 2016

SIMPSON MEMORIAL SCHOLARSHIP

APPLICATION FORM

**Please complete in blue or black ink or type. Additional pages may be attached. A transcript is available from your school counseling office and must be attached to this application. (Required information *)

*Applicant's Full Name *Social Security #

*Gender *Date of Birth *Country of Citizenship

*Phone *Email

*Parent(s) or Guardian(s)

*Address

*Accepted by (colleges or universities)

(To be filled in by counselor): *Class Rank *GPA

Scholastic Honors

Extra-curricular Activities (include number of years and offices held)

Community Activities (include number of years and offices held)

Please reply to the following questions in essay form. Use the other side of this sheet if necessary.

Describe your planned course of studies and educational goals and tell why you have selected this field:

Explain why you need and will benefit from this scholarship:

FINANCIAL STATEMENT

I. Student Employment (Includes full or part-time during the last two years):

Employer Type of Work Employed Weekly

From To Earnings

Amount you have saved toward higher education

II. Family Income

Occupation Annual Income

Father

Mother

*Other

Total Family Income

*Specify by source, such as Social Security, Veteran's benefits, income of other family members, or investment income.

**Copy of FAFSA (Free Application for Federal Student Aid) or SAR (Student Aid Report) must be submitted with this application.

III. Estimated Expenses for one school year:

Tuition & Fees Transportation

Room & Board Clothing

Books & Supplies Laundry

Medical, incl. Insurance Other

Total Estimated Expenses

IV. Expected Financial Resources (per year):

From Family From Other Scholarships

From Earnings From Contributions

*From other Sources

Total Expected Resources

*Specify by source, such as trust funds, insurance, etc.

V. Other Dependents in Family

Name Age If student, name of school

______

______

______

I/We declare the information in this application and financial statement to be true and accurate, to the best of my/our knowledge.

______

Signature of Student Signature of Parent(s) or Guardian(s)

I authorize the release of transcript to the Scholarship Committee so that he/she may be considered for this scholarship.

______

Signature of Student Signature of Parent if student is Date

under 18 years of age