APPLICATION INFORMATION

GREATER ST LOUIS MOTHERS OF TWINS CLUB, INC

CONTINUING EDUCATION AWARD

IN MEMORY OF MARY JOAN WOLF

FOR THE ACADEMIC YEAR 2016-2017

--For Graduating High School Seniors Only--

APPLICATION DEADLINE: FEBRUARY 17, 2017

The following information/forms must be sent:

1) From the school: An official transcript and a list of current course enrollment

2) From TWO references: Letters of recommendation from two individuals

not related to the applicant

3) From the applicant:

a) The completed application – all pages and information MUST be completed for

the applicant to be considered for the award

b) Copies of birth certificates or other official documents showing that the

applicant is a multiple-birth child

c) An essay of no more than 300 words on: “WHAT ADVICE WOULD I GIVE TO PARENTS OF MULTIPLES?”

THE APPLICATION MATERIALS MUST BE RECEIVED FROM ALL THREE SOURCES BY FEBRUARY 17, 2017.

Completed materials should be mailed to;

Attn: Scholarship Chair

Greater St Louis Mothers of Twins Club, Inc

P O Box 31382

Saint Louis, MO 63131-0382

App #______ (For Office Use Only)

GREATER ST LOUIS MOTHERS OF TWINS CLUB INC

CONTINUING EDUCATION AWARD IN MEMORY OF MARY JOAN WOLF

FOR ACADEMIC YEAR 2016-2017

Please type or clearly print all information. All information contained herein is confidential and will be used only by the selection committee to make their decision.

NAME______

(Last) (First) (Middle)

ADDRESS______

(Number & Street) (City) (State) (Zip)

PHONE (______)______

Date of Birth______Social Security Number______

Birth Status of applicant (circle one): Twin Triplet Quadruplet Other (specify)______

Is your mother a current or past member of the St Louis Mothers of Twins Club______

(For informational purposes only. Response will not affect consideration for award.)

High School or last school attended______

Graduation date or anticipated graduation date______

AGREEMENT

I have read and fully understand the eligibility requirements of the Greater St Louis Mothers of Twins, Inc. Continuing Education Award in Memory of Mary Joan Wolf.

To the best of my knowledge and ability, the information in this application is correct.

I fully understand that any misrepresentation of information contained in this application may revoke any rights to the award.

If I do not graduate from the school in which I am enrolled now and do not qualify for the award as stated, I will forfeit any rights to this award.

Signature of Applicant______Date______

Signature of Parent or Guardian______Date______

App. No.___

APPLICATION

AWARDS: List any distinctions or awards for scholastics, academics, athletics, or other.

Include any that are unique to your school. Attach additional pages if necessary.

Name of Award Awarded For Year

______

______

______

______

ACTIVITIES: List any school activities and membership in school organizations. Attach additional pages if necessary.

Activity Responsibilities From/To

______

______

______

COMMUNITY SERVICE: List all volunteer, youth, civic, religious, or other activities in which you have been involved. Attach additional pages if needed.

Activity/Volunteer Experience Responsibilities From/To

______
______
______
______

______

App. No.___

WORK EXPERIENCE: List any positions you have held in the past three years.

Employer Phone Responsibilities From/To

______

______

______

______

FUTURE EDUCATIONAL PLANS: List the schools to which you have applied in your order of preference. Indicate whether you have been accepted yet.

School Location Accepted?

______

______

______

______

What are the reasons for your first preference in schools?

______

______

What is your area of interest or probable major? ______

______

List any extenuating circumstances that you feel should be considered that are not included in this application.

SCHOLARSHIP INFORMATION:

The Greater St Louis Mothers of Twins Club Inc presents two (2) Continuing Education Awards annually in memory of Mary Joan Wolf – one of our founding members. The awards are presented to multiple birth children who are graduating from high school the year of the award to fund their continuing education either in college, junior college, or professional trade schools. Applicants must complete and sign the application and return to the Scholarship Chair. To be considered for the award, the Scholarship Chair must also receive copies of birth certificates to show the multiple birth, an official transcript and a list of current courses being taken from the applicant’s school, two letters of recommendation for the applicant from individuals who are not related to the applicant, and an essay of no more than 300 words written by the applicant on the topic shown on the application information. If the applicant is judged to be one of the recipients of the award and then does not graduate and/or does not continue their education, the award is forfeited. The awards are judged individually and both/all multiples do not have to submit applications. Greater St. Louis MOTC determines the amount of the award annually. The check is made payable to the recipient and the school to be used however the recipient determines for school expenses after the recipient produces evidence of attendance/registration. One-half of the award is issued for the first semester and upon submitting evidence of attendance/registration for the second semester, the second half is issued.

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