P.E.O., Chapter XE - Local Scholarship Committee Attention: MaryBeth Larusson Donner Pass Rd Ste C1 #196 Truckee, CA 96161

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1 Dear Student and Parent: The P.E.O. Sisterhood is an international philanthropic educational organization that promotes educational opportunities for women through grants, loans and scholarships. The P.E.O., Chapter XE Local Scholarship (Joan Kelly Memorial) was established in 2002 to provide scholarships to Truckee High School senior female students who plan to attend a four year college, have maintained a minimum of a 3.5 GPA and have been involved in community and/or school activities throughout their high school years. The scholarship committee will base their selection on four criteria: Scholastic, (transcripts, test scores), Personal (essay), Extracurricular Activities (community service, sports, work, student government, clubs, etc.), and Financial Need. Scholarships will be awarded at the Truckee High School Evening of Excellence and announced at the Graduation Ceremony. APPLICATION INSTRUCTIONS Student Directions: 1. Complete application (available online and/or in the counseling office), and write responses in ink in the spaces provided. Illegible applications will not be considered. Please be sure to complete all areas of the application. 2. Distribute the recommendation forms ASAP. It is required that this form be given to both a SCHOOL (e.g. principal, teacher, counselor, or school coach) and a NONSCHOOL source (e.g. employer, minister, non-school organization/club advisor, non-school coach, or adult family friend). Family members should not submit any recommendations. Parent Directions: 1. Complete the financial data form ONLY if your student has financial need. The EFC number determines the level of financial need. If you have difficulty completing the financial need form, please ask your career technician or counselor. 2. Guide your student to two appropriate people for a recommendation who can evaluate their most positive attributes. 3. Review your student s application for accuracy. Deadline: Mail or completed application to the address listed below, or deliver to the Truckee High School Counseling office by 3pm on Friday April 19th, P.E.O., Chapter XE - Local Scholarship Committee Attention: MaryBeth Larusson Donner Pass Rd Ste C1 #196 Truckee, CA mb.larusson@yahoo.com

2 Welcome to the P.E.O., Chapter XE - Local Scholarship Application Please read these instructions carefully. 1. There are 7 pages to fill out or include in the application. Please be sure that all pages are completed, and submit them in the following order: Student Information: Statistics, Educational Plans, Work Experience, Signatures. Activity Summary: Community and School Activities, please use the form included. Personal Essay: Confine to one page, 500 words maximum, using 12 pt.font. Letters of Recommendation: Two letters of recommendation are required, both a SCHOOL and NONSCHOOL source. Distribute to appropriate sources ASAP. Letters of Recommendation should be either attached in a sealed envelope, mailed or ed directly to the address listed below: Transcripts and Test Scores: Please submit a copy of your transcripts and a copy of your SAT/ACT scores with your application (unofficial copies are acceptable). Financial Need Information: Read carefully and have a parent complete. Please note that this page is optional. 2. The P.E.O., Chapter XE local scholarship committee may request an interview in the effort to determine the most eligible student. You will be notified in advance if an interview is requested. If a Scholarship is awarded, the following procedures must be followed: 1. The student will be expected to send a thank you note to P.E.O., Chapter XE and may be asked to visit and present a brief program about her educational experience to the local chapter. 2. Once enrolled in college, the student must obtain official verification of her enrollment from the registrar, certifying enrollment as a full-time student. 3. The official verification of enrollment, and a letter stating where the scholarship check should be mailed, should be forwarded to the address listed below. 4. All requirements must be met by June 30th of the following year. An extension may be granted upon a written request sent to the address below by the June 30th deadline. A check will be mailed to the student ONLY after completion of above requirements. Contact Address: P.E.O., Chapter XE - Local Scholarship Committee Attention: MaryBeth Larusson Donner Pass Rd Ste C1 #196 Truckee, CA mb.larusson@yahoo.com

3 P.E.O., Chapter XE Local Scholarship Application Applicant Name: Mailing Address: Physical Address: Home Phone: Cell Phone: Address: Please indicate if you have any P.E.O. affiliation (mom, sister, aunt, grandmother): Name/Relationship/Chapter: Letter of Recommendation: List name and phone number of the persons receiving the recommendation form (both a SCHOOL and a NON-SCHOOL source) Name/Title: Phone: Name/Title: Phone: GPA (weighted/non-weighted) Class Rank of in class Educational Plans I plan to attend the following college (name and location): 1st Choice: 2nd Choice: Planned Major(s): Occupational Goal(s): Work Experience and/or Internships related to your field of interest: Summary of Work If you have worked, list the places and types of employment: If you are working now, how many hours per week? How many classes a day do you take in school? I declare the information included in this application to be correct to the best of my knowledge Parent Signature: Student Signature:

4 Activity Summary Be sure to include special honors received, offices held and leadership skills acquired. Community Involvement: Include church youth groups, scouts, service groups, social or lodge groups, etc. that you participated in for more than 20 hours during your high school years. List your activity and the school year of involvement. 9th 10th 11th 12th Activity and amount of involvement: School Involvement: List membership in clubs and student body offices. Also include athletics, music, drama, journalism, etc. during your high school years. 9th 10th 11th 12th Activity and amount of involvement: Other Interests: Include non-school related activities such as hobbies, dance, and musical interests that you have not previously mentioned.

5 Personal Essay Please attach a one-page, 500 word maximum essay in a 12-point font. Include your feelings about your future, your immediate plans, and your more distant aspirations and how you intend to accomplish your goals. Include any information unique or significant to your background. You DO NOT need to include or repeat information that appears in the earlier sections of this application unless applicable. Remember that this page is your only chance to give the screening committee an idea of your personality and character. Please limit your essay to one page only. Be sure to put your name at the top left-hand corner and attach to the application in the position indicated in the instructions. The two paragraphs on this page do not have to appear at the top of the essay page, so you can use the entire page for the essay.

6 Recommendation for Scholarship Applicants - School Source This student is applying for the P.E.O., Chapter XE Local Scholarship Please comment on the student with regards to their citizenship, initiative, self-discipline, and other relevant characteristics. Please avoid listing accomplishments as these are listed by the student elsewhere. Please confine your comments to one page only, due to time constraints, it is not possible to read long recommendations. The two paragraphs on this page do not have to appear at the top of the recommendation form. If you choose to start with a blank page, please remember to write the student s name at the bottom along with your signature and relationship to the student. You may either mail or the completed recommendation to the address listed below or give to the student in a sealed envelope. This must be received by Friday April 19th, Signature: Relationship to Student: Student Name: Please return this completed form to the student, mail or to: P.E.O., Chapter XE - Local Scholarship Committee Attention: MaryBeth Larusson Donner Pass Rd Ste C1 #196 Truckee, CA mb.larusson@yahoo.com

7 Recommendation for Scholarship Applicants - Non-School Source This student is applying for the P.E.O., Chapter XE - Local Scholarship Please comment on the student with regards to their citizenship, initiative, self-discipline, and other relevant characteristics. Please avoid listing accomplishments as these are listed by the student elsewhere. Please confine your comments to one page only, due to time constraints, it is not possible to read long recommendations. The two paragraphs on this page do not have to appear at the top of the recommendation form. If you choose to start with a blank page, please remember to write the student s name at the bottom along with your signature and relationship to the student. You may either mail or the completed recommendation to the address listed below or give to the student in a sealed envelope. This must be received by Friday April 19th, Signature: Relationship to Student: Student Name: Please return this completed form to the student, mail or to: P.E.O., Chapter - XE Local Scholarship Committee Attention: MaryBeth Larusson Donner Pass Rd Ste C1 #196 Truckee, CA mb.larusson@yahoo.com

8 Financial Need Information (Optional) Completing this financial data form is not an eligibility requirement for our scholarship. However, the committee will assume the applicant has no financial need if it is not completed. 1. Did you complete the FAFSA (Free Application for Federal Student Aid)? 2. If you completed the FAFSA, what was your EFC (Expected Family Contribution)? 3. Besides you, how many brothers/sisters will be in college next year? 4. Besides you, how many brothers/sisters will be living at home next year? 5. Father s or Legal Guardian s highest level of education? 6. Father s or Legal Guardian s occupation? 7. Mother s or Legal Guardian s highest level of education? 8. Mother s or Legal Guardian s occupation? 9. Approximate gross family income? $ (In the case of divorce, please list each parent s gross family income separately and note which parent the student spends more than half the time with if applicable.) 10. The committee recognizes that special circumstances (1.e. disabilities, divorce, unemployment, etc.) may affect your ability to help your student. Please explain any special circumstances.