KECSAC Outstanding Student of the Year

Checklist

Application (Student must have been enrolled in a state agency program at some time during the current school year)

Current Transcript(Student should have a minimum GPA of 2.0)

Student Essay

Principal’s/Administrator’s Recommendation

Letter of Recommendation from Teacher, counselor, or community member

Photo Release Form

The completed application is due in the KECSAC office no later than 5:00 p.m. on March 31, 2017, but may be submitted any time during the year.

Nominations may be mailed to:

Kaye Parker

Martin House

Eastern Kentucky University

521 Lancaster Avenue

Richmond, KY 40475

Or emailed

KECSAC Outstanding Student of the Year Application

This award is designed to recognize a state agency child who has demonstrated exemplary efforts in overcoming personal and educational obstacles to attain educational goals. The award will be presented to a high school senior.

Student’s Full Name: ______Phone: ______

Student’s Home Address: ______Zip Code: ______

Legal Guardian’s Name: ______

Permanent Address: ______

State Agency Program: ______

Current cumulative GPA (must be a 2.0 or better if college bound): ______. Please attach an official transcript.

Student’s Signature: ______

Principal’s/Administrator’s Signature: ______

STUDENT ESSAY (PLEASE ATTACH)

Nominated students must write an essay about overcoming adversity.

1. Explain in your own words the adversities you have encountered.

2. Describe your educational and career goals.

3. Describe how this scholarship will help you reach your goals.

PRINCIPAL’S/ADMINISTRATOR’S RECOMMENDATION (PLEASE ATTACH)

The program principal/administrator must write a recommendation for the student and should discuss the following points:

a. Personal obstacles/issues that the student has overcome – focus on where they were then and where they are now.

b. Characteristics that make the student outstanding.

c. Demonstrated progress in the program (social, emotional, discipline, etc.).

d. The student’s educational progress.

e. The student’s personal interests.

f. Community service activities in which the student is involved.

g. Any other information you feel is important for the selection committee to know about your student.

LETTERS OF RECOMMENDATION (PLEASE ATTACH)

The student must get one (1) letter of recommendation. The letter could be from a teacher a counselor, or community member.

IMPORTANT NOTICE - Student Conduct

The KECSAC Outstanding Student Award will be presented to a student who has exhibited personal strength in overcoming obstacles. This recipient of the award will be a role model for other KECSAC students. Should the winner engage in unlawful activities or unacceptable acts of behavior between the time the student is notified and the award is presented, the award will be withdrawn and awarded to the runner-up candidate.

Dear Student:

Should you be selected for the KECSAC Outstanding Student Award, KECSAC requests the right to photograph you. Your image will be used in promotional material including, but not limited to, newsletters, reports, posters, brochures, and the KECSAC website. We cannot publish your image unless the form below has been signed by you or your parent/guardian. Please sign the form below or, if under 18 years old, ask your parent/guardian to sign for you.

Thank you.

KECSAC Photo Release Form

I hereby grant KECSAC the right to photograph me and use the photo or other digital reproduction for publication processes, whether electronic, print, digital or electronic publishing via the Internet, without compensation to me.

Date:______

Printed Name of Student: ______

Signature of Student:______

I am the legal parent/guardian of the child above and I give permission for KECSAC to photograph my child and use the photo or other digital reproduction for publication processes, whether electronic, print, digital or electronic publishing via the Internet, without compensation to me or my child.

Date:______

Printed Name of Parent/Guardian: ______

Signature of Parent/Guardian: ______

Address: ______

KECSAC Outstanding Student of the Year Award Instructions

Process Time Frame

The completed application is due in the KECSAC Office no later than 5:00 p.m. on March 31, 2017; however, applications may be submitted at any time during the year.

Nominations may be mailed to:

Kaye Parker

Martin House

Eastern Kentucky University

521 Lancaster Avenue

Richmond, KY 40475

Or emailed to

Award

The recipient of the KECSAC Outstanding Student of the year award will receive a nonrenewable monetary award of $500. The monetary award may be used at any Kentucky post-secondary program (i.e., vocational school, trade school, community and Technical College, four-year College, etc.) that follows federal student loan guidelines. Award will be paid directly to the educational institution chosen by the student and may be used for any school related expense for the student. Funds must be utilized in the school year following the award. Example: funds awarded in May 2017 must be utilized before June 30, 2018.

The award winner must provide KECSAC with the name of the educational institution the student plans to attend at least four weeks prior to the beginning of the first semester.

Presentation of Award

Award will be presented to the selected student during the annual Alternative Strategies for Educating Students At-Risk Summitin July 2017.The expectation is that the student will be present at the conference to receive the award.