Louise S. Henderson and Catharine R. Parrett Scholarship

LOUISE S. HENDERSON AND CATHARINE R. PARRETT SCHOLARSHIP

Selection Criteria

The recipient must be:

1. A female

2. A citizen of the United States*

3. A resident of the Washington Metropolitan Area**

4. Priority will be given to women in the following categories:

a) A homemaker with limited career skills who would like to pursue or complete studies in her desired field.

b) A working woman seeking to advance her skills or earning power.

c) A full-time upper class or graduate student in need of financial assistance to complete her studies.

d) Currently enrolled in a college, university or certificate program.

5. Must be a high school graduate or have equivalent educational training.

The dollar amount of the scholarship may vary. The anticipated amount to be awarded this year is $1,000 (one thousand dollars).

If you meet the above criteria and are interested in applying for the scholarship, please copy and complete the attached four page application.

Email to: OR

Mail the application to:

Henderson-Parrett Scholarship

Jeanne Sampson

5209 York Rd.

Alexandria, VA 22310

PLEASE NOTE: ALL APPLICATIONS ARE DUE APRIL 1, 2015

Late applications will not be considered.

*Consideration of an applicant will not be limited to age, race, religion or creed.

**Including, and limited to, the District of Columbia; the cities of Falls Church, Alexandria, and Fairfax, VA; Fairfax and Arlington counties in VA and Montgomery and Prince Georges counties in MD.

Louise S. Henderson and Catharine R. Parrett Scholarship Fund

Application: Academic Award Year 2015-2016

Name: Full Legal Name

Address: Street, City, State, Zip

Telephone: Daytime Phone h

Email:

Age: Marital Status: Single Married Widow/Separated/Divorced

Dependents:

Name: Age: Child Parent Sibling Other

Occupation/Job Title:

Employer Name:

Work Address:

Work Telephone:

Education Background

Current College / University:

Location:City, State

Student ID Number or SSN: Only one is needed

Freshman Sophomore Junior Senior Other: Graduate Program

Expected Month and Year of graduation: Major:

Name / Dates Attended / Degree / GPA*
High School / N/A
College
Other

*GPA - grade point average

List Community Awards or Academic Honors:

State your educational goals and how this scholarship might support them:

List all current financial aid or debt:

Type / Amount / Status of Aid or Debt
Student LoanPersonal LoanHome MortgageCredit Card / DeferredRepaymentRepaid
Student LoanPersonal LoanHome MortgageCredit Card / DeferredRepaymentRepaid
Student LoanPersonal LoanHome MortgageCredit Card / DeferredRepaymentRepaid
Student LoanPersonal LoanHome MortgageCredit Card / DeferredRepaymentRepaid
Student LoanPersonal LoanHome MortgageCredit Card / DeferredRepaymentRepaid

Why is it necessary for you to receive financial aid?

(brief statement of financial need)

Are you: A citizen of the United States of America? Yes No

A member of the P.E.O. Sisterhood? Yes No

Is there any relationship between you and:

a) A member of the P.E.O. Sisterhood? Yes No

b) A trustee of the P.E.O. Foundation? Yes No

c) An Officer of the P.E.O. Sisterhood? Yes No

d) A member of the Scholarship Selection Committee? Yes No

e) A grantor or substantial contributor to the P.E.O. Sisterhood? Yes No

f) A coporate grantor or contributor to the P.E.O. Sisterhood? Yes No

g) A family member of ‘e)’ above? Yes No

h) A member of the family of Louise S. Henderson? Yes No

i) A member of the family of Catharine R. Parrett? Yes No

References

Please provide names of three references. Indicate whether each is a professional or personal reference.

Name: Relationship

I certify that the information contained in this application and accompanying confidential financial statement is true and accurate to the best of my knowledge.

______

Signature of Applicant

______

Date

E-mail completed application materials by April 1st, 2015, 11:59 pm Eastern:

Mail completed application materials to the following address, postmarked by April 1st, 2015:

Henderson-Parrett Scholarship

c/o Jeanne Sampson

5209 York Rd.

Alexandria, VA 22310

Confidential Financial Statement

Gross Salary or Wages:

2013:

2014

Other sources of income during 2014:

Description / Source / Amount

Total value of savings and investments:

Your Home: Own Rent

Monthly housing expense:

Current Credit Obligations:

Creditor / Amount Owed

PLEASE NOTE: The information supplied above will remain strictly confidential and is used solely as one factor in determining qualifications for awarding grants under the Louise S. Henderson and Catharine R. Parrett Scholarship Fund. Application materials shall be destroyed in a secure manner (e.g. shredded or incinerated).

Applications must be e-mailed by April 1st, 2015, 11:59 pm Eastern:

Postmarked by April 1st, 2015

Late Applications will not be considered