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:

  1. Be a resident of ForsythCounty for a minimum of one year prior to submission of

application.

  1. Be accepted for enrollment as a full-time student in an accredited college or vocational school.
  1. 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

  1. 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.
  1. Submit three letters of recommendation with application, one of which must be from a school staff member and none from family members.
  1. School counselor is to complete and verify pages five and six of application. If notcompleted andsigned bycounselor, application will not be considered.
  1. 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.

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DeSANA EDUCATIONAL FUND, INC.

320 Dahlonega Street

Cumming, Georgia 30040-2410

Phone – 770-889-4050

Fax – 770-889-7215

Email –