ALGER REGIONAL COMMUNITY FOUNDATION
SCHOLARSHIP APPLICATION FORM
FOR THE
PAUL & ALICE SIMONEN SCHOLARSHIP
Date ______
Applicant Information
Name ______
Address ______
City, State, Zip ______
Phone ______
Social Security No. ______
Age ______
Family Information (please provide information where applicable)
Name of Father/Stepfather/Guardian ______
Address ______
City, State, Zip ______
Name of Mother/Stepmother/Guardian______
Address ______
City, State, Zip ______
Number of Siblings ______
Number in College (do not include yourself)______
Name of Spouse ______
Number of Dependents (including yourself) ______
Year of High School Graduation ______
High School Attended ______
GPA ______
School planning to attend ______
Field of Study ______
(If Applicable).... Since high school graduation I have been
In the military______
Working full-time ___ part-time___
Where______
Attending Classes full-time___ part-time___
Where______
Field of Study ______GPA ______
Year in College during coming year:
Fr.____
So.____
Jr.____
Sr.____
Grad. _____
Approximate annual costs of school you are/will be attending (including room & board) ______
Probable amount of financial support from family ______
Probable amount of financial support from other sources ______
Three (3) Letters of Reference. Ask individuals to briefly describe how they know you. Have them indicate within their narrative whether they feel you have worked to your full potential in the area or activity that they know you. Reference letters should accompany the application.
Applications will not be considered complete until all 3 letters have been received.
Please use additional pages as needed to complete the following
Indicate special awards, honors, recognition received during the past four years in order of their importance to you________
______
______
List community/school activities in which you have participated during the past four years in order of their importance to you ______
______
______
List work experience during past four years ______
I hereby affirm that the information provided on this form is accurate and complete to the best of my knowledge
Signature ______
______
Notes: (office use only)
PAUL & ALICE SIMONEN SCHOLARSHIP
The Paul & Alice Simonen Scholarship is offered to any Alger County resident planning to pursue post-secondary education at a college, university, vocational, or technical institute.
Preference will be given to an individual with future potential as evidenced by an exceptional record of achievement in school, community, and/or employment. Examples of achievement may include, but are not limited to, areas such as
academics, fine arts, athletics, technology, volunteerism, service clubs,
work/military experience.
All reference responses must also be received by the deadline indicated or the application will be considered incomplete.