DeSANA EDUCATIONAL FUND, INC.
UNIFORM SCHOLARSHIP APPLICATION
2014
(THIS APPLICATION IS TO BE USED TO APPLY FOR THE FOLLOWING SCHOLARSHIPS)
JIM & JEANNE DeSANA SCHOLARSHIP
DR. ELISABETH MARTIN DARLOW SCHOLARSHIP
AWARD
$5,000.00 Scholarship will be awarded and distributed over a four year period. $2,000.00 will be funded the first year, $1,000.00 in each remaining year contingent upon recipient maintaining a GPA of 3.0 or better each prior year. Award will be presented at recipient’s school honors program.
QUALIFICATIONS – APPLICANT MUST:
- Be a resident of ForsythCounty for a minimum of one year prior to submission of
application.
- Be accepted for enrollment as a full-time student in an accredited college or vocational school.
- Be a ForsythCounty high school graduate in year applying for scholarship.
APPLICATION
Print or type responses to questions. Applicationmust be completed and turned in to the Guidance Counselor’s office byApril 15, 2014.
SELECTION CRITERIA
Application for scholarship will be considered on the basis of financial need, demonstrated leadership skills, extra-curricular activities, academic performance, academic and other scholastic awards, and community involvement. Scholarship recipient will be chosen by a committee composed of the Board of Directors of the DeSana Educational Fund, Inc. The decision of the Selection Committee will be final.
ADDITIONAL REQUIREMENTS
- Attach a copy of the applicant’s completed Free Application for Federal Student Aid (FAFSA), the Student Aid Report (SAR)and determination of aid eligibility letter. If FAFSA is not available submit pages 1 and 2 of parent(s) previous year Form 1040 income tax return.
- Submit three letters of recommendation with application, one of which must be from a school staff member and none from family members.
- School counselor is to complete and verify pages five and six of application. If notcompleted andsigned bycounselor, application will not be considered.
- A copy of applicant’s official Forsyth County High School Transcript, signed by counselor, must be attached to application.
NOTICE: Please utilize front of page only and add pages as needed.
APPLICANT NAME: ______PHONE:______
ADDRESS: ______EMAIL: ______
CITY/STATE/ZIP CODE: ______DATE OF BIRTH: ______GENDER: ___
HIGH SCHOOL:______
PARENT(S) NAME(S): ______
SIBLING NAME(S)AND AGE(S): ______
______
RESIDENCY: Applicant certifies that he/she is a legal resident of United States of America.
LIST SIGNIFICANT HONORS/AWARDS/ACHIEVEMENTS: GRADE
______
______
______
LIST COLLEGES WHERE YOU HAVE BEEN ACCEPTED IN ORDER OF YOUR CHOICE:
1. ______
2. ______
3. ______
YOUR PLANNED COURSE OF STUDY: ______
YOUR INTENDED CAREER CHOICE: ______
LIST ACTIVITIES/INTERESTS IN AND OUT OF LEADERSHIP
SCHOOL IN ORDER OF IMPORTANCE TO YOU: GRADE POSITIONS HELD
______
______
______
______
LIST COMMUNITY ACTIVITIES IN WHICH YOU HAVE PARTICIPATED WITHOUT COMPENSATION:
ORGANIZATION NAME WORK DESCRIPTION YEAR SPECIAL HONORS
______
______
______
______
WILL YOU BE WORKING WHILE ATTENDING COLLEGE? IF SO, WHERE? ______
LIST TWO PREVIOUS EMPLOYERS, IF ANY:
EMPLOYER NAME POSITION HELD YEAR
______
______
LIST SOURCES OF FINANCIAL AID AND SCHOLARSHIPS FOR WHICH YOU HAVE QUALIFIED OR HAVE BEEN AWARDED:
SOURCE DOLLAR VALUE
______$______
______$______
______$______
______$______
ESSAY QUESTIONS (Respond briefly in writing to the following):
1. Which academic achievement gives you the greatest feeling of personal accomplishment?
______
______
______
2. Which of your talents, interests or activities means the most to you and why? ______
______
______
______
3. Explain if and how a particular book, play, film, work of art, or piece of music influencedyou.
______
______
______
4. Why is this scholarship important to you? ______
______
______
5. Describe yourself and interests you have. Include a brief self-evaluation of your strengths and
weaknesses. ______
______
______
______
6. Is there anything specific you would like known about you and your life circumstance?
______
______
______
I CERTIFY THAT ALL INFORMATION IN THIS APPLICATION IS ACCURATE AND COMPLETE.
Applicant Signature (Required): ______Date: ______
THIS PAGE MUST BE COMPLETED AND SIGNED BY GUIDANCE COUNSELOR
Applicant name: ______High School:______
Honors Night date: ______Time: ______
Critical
Applicant’s SAT scores: Math ____ Reading ____ Writing ____ Applicant’s ACT score: ____
Has applicant been enrolled in advanced placement (AP) classes? ______
I have signed and attached a copy of applicant’s official Forsyth County High School Transcript.
COUNSELOR EVALUATION OF APPLICANT:
DESCRIPTIVE WORDS
CHECK ALLYOU FEEL ACCURATELY
THAT APPLY DESCRIBE APPLICANT COUNSELOR’S COMMENTS
______Academic______
______Ambitious ______
______Artistic______
______Athletic______
______Career oriented______
______Community minded______
______Focused______
______Goal oriented______
______Hard-working______
______Intelligent______
______Leader______
______Motivated______
______Open-minded______
______Optimistic______
______Over-achiever______
______Responsible______
______Role model______
______Self-centered______
______Self-confident______
______Sports enthusiast______
______Strong personal values______
______Well read______
______Well rounded______
Counselor’s overall personal rating of applicant (1 is lowest, 10 is highest) ______
I CERTIFY THAT THE INFORMATION PROVIDED IS ACCURATE AND COMPLETE.
Counselor Signature (Required): ______Date: ______
Counselor email address: ______
A DeSANA FUND REPRESENTATIVE WILL PICKUP APPLICATION FROM COUNSELING OFFICEBY 12:00 P.M. ONAPRIL 16,2014.
1
DeSANA EDUCATIONAL FUND, INC.
320 Dahlonega Street
Cumming, Georgia 30040-2410
Phone – 770-889-4050
Fax – 770-889-7215
Email –