Catherine and Homer Thomason
Nursing Scholarship Fund
When Mrs. Thomason passed away, she wanted to establish a Nursing Scholarship program for Jefferson County. She requested that Countryside Bank, Meriden, be the Trustee for this program. This is the 1st Annual Jefferson County Nursing Scholarship program that will be rewarded to a student within any Jefferson County High School.
Thank you for applying for this Annual Jefferson County Scholarship and good luck!
Jason L. Pickerell
Vice President Countryside Bank
Benefits: Scholarship award ------$1000 min., $2000 max. (non-renewable)
Selection
Criteria: Scholarship applicants must:
~ Read the summary about Catherine (above)
~Have an accumulative GPA of 3.0 or above
~Be a Senior in a Jefferson County School
~Enroll for classes for the Fall, 2012 semester
~Attend an accredited college, university, or Nursing School
~Be a well-rounded individual, committed to academic
excellence and community service
~Provide a Letter of Recommendation from either a School
Counselor or someone currently in the Medical Profession.
To Apply: Applications are available in the counselor’s office.
Deadline: Completed applications must be received in the counselor’s
Office no later than 3:00 p.m. on Monday, April 2, 2012.
Name: ______
Address: ______
______
Parent’s
name ______
Telephone # ______
2012 CATHERINE AND HOMER THOMASON NURSING SCHOLARSHIP APPLICATION
Name of Applicant
Address
City/State/Zip Code
This section needs to be completed by the high school counselor before the form is forwarded to the scholarship committee.
Student's GPA ______Class Rank _____/_____ ACT Composite
Counselor's Signature
SCHOOL ACTIVITIES
List all activities in which you have participated during high school. Include clubs, teams, musical groups, community service learning projects, etc. and major accomplishment in each of them.
(add additional spaces as necessary)
Activity Year Accomplishments
(9, 10, 11, 12)
______
______
______
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LEADERSHIP ACTIVITIES
List all elected or appointed leadership positions held in school, community, or work activities. For example, student body, class or club officer, committee chairperson, team captain, newspaper editor, or community leader.
(add additional spaces as necessary)
Position Year Activity or Organization
(9, 10, 11, 12)
______
______
______
______
______
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COMMUNITY INVOLVEMENT:
List all community activities in which you have participated and note any major accomplishments in each. EX. Church groups, clubs sponsored outside the school, i.e. Boy or Girl Scouts, 4-H, volunteer groups or community art endeavors.
(add additional spaces as necessary)
Community Involvement Year Major Accomplishment
______
______
______
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WORK EXPERIENCE:
List below any job experience.
(add additional spaces as necessary)
Job Year Group or Activity
(9, 10, 11, 12)
______
______
______
What college, university or technical school are you planning to attend?
______
Write an autobiographical sketch about yourself. You might include your leisure time activities, your hobbies, thoughts about your future, and your career plans. Please limit your autobiography to one page.