Herb Block Scholarship Scholarship Application

Transcription

1 Herb Block Scholarship Scholarship Application If you have internet access you may apply online at There are many benefits to applying online. A few include: You can start and stop the application at any time before the deadline. Your entered data is saved. You will receive incomplete reminder s if your online application is not complete. If a required document is missing information and is rejected, you will receive an . If you forget to enter any required fields, you will be alerted when you try to submit online. Who is eligible to apply? Applicants must be a high school graduate, GED or other diploma equivalent holder or a current community college student and meet all of the following criteria to be eligible for this scholarship: maintain your primary residence in: o Washington, DC o Montgomery or Prince George s County, MD o Arlington or Fairfax Counties, or the cities of Alexandria or Falls Church, VA have earned a high school diploma -ORbe eligible to graduate from high school by July 7, ORhave attained a GED or other diploma equivalent accepted by the State of Maryland, the Commonwealth of Virginia or the District of Columbia be an enrolled student, or plan to enroll at the first opportunity, at one of the four participating community colleges in at least 6 credits per semester o Community College of the District of Columbia o Montgomery College (all campuses) o Northern Virginia Community College (all campuses) o Prince George s Community College have not previously earned a bachelor's degree, an associate's degree, or a vocational certificate at any post-secondary institution in the United States have not completed the 40th credit towards a degree before the beginning of the first semester in which the scholarship would be received demonstrate financial need by completing the Free Application for Federal Student Aid (FAFSA) and supplying a copy of the Student Aid Report (SAR). No exceptions will be made to the eligibility criteria. Award details: The awards will be up to $8,000 per academic year and up to $16,000 over the life of the scholarship. Approximately 100 scholarships are awarded annually and are renewable for up to 5 years, provided that the student continues to meet all other eligibility criteria and has not reached the monetary cap. It is a last dollar scholarship, meaning that the calculation of the student s need takes into account all other financial aid awards the student receives. The scholarships will be applied to tuition, fees, books, supplies, and equipment required for course load, at one of the 4 eligible colleges listed above. Limited transportation costs and child care expenses will also be considered. The Herb Block Scholarship is transferable within the participating community colleges only. Selection Criteria: An independent selection committee of college admissions and financial aid professionals will evaluate the applications. No member of the committee is connected with The Herb Block Foundation. Please note that applicants must demonstrate financial need and will be reviewed under one of three categories of academic achievement: A and B-level students, C-level students showing continuous academic improvement, and adult learners and students applying with GEDs or other equivalency diplomas. Decisions of the selection committees are final and are not subject to appeal. No application feedback will be given. Application Deadline There are two scholarship deadlines each year. Applications for the fall semester are due July 7 th and applications for the spring semester are due November 10 th. Fall semester applicants who do not receive the award are automatically re-considered for an award for the spring semester.

2 Notification and Recipient Responsibility: Notifications are sent approximately two months past the deadline. If you are selected as a recipient, you will receive further information on accepting the award in the award letter. Winner and non-winner notifications will be sent by . Be sure to add ContactUS@applyists.com to your address book or safe senders list so these important s are not sent to your junk mail folder. Do not opt out of any sent from ContactUs@applyists.com or you may not receive vital information regarding your scholarship applications. If you are selected as a recipient, you must enroll at one of the participating community colleges in the year in which the scholarship is awarded; you must be enrolled for at least 6 credit hours per semester to receive funding from the Herb Block Scholarship. You must continue in school the entire academic year without interruption unless approved by the scholarship sponsor. You must deliver the scholarship check(s) to the proper office at the recipient s institution. Checks are mailed to your home address as displayed on the My Profile page at and made payable to the institution listed on the My Profile page. To access your My Profile go to and login using the address you provided on the application. Click the I forgot my password link to set up a password. The green My Profile tab will be on your homepage. Note: Your address will only be used for communication about your scholarship applications or other opportunities administered by ISTS for which you may be eligible to apply. We will not provide your address to any third-parties. Decisions of the selection committees are final and are not subject to appeal. No application feedback will be given. Checking the Status of the Application: Allow 2-3 weeks after submitting all of the information for processing. Go to and login using the address you provided on the application. Click the I forgot my password link to set up a password. Your status will be displayed on your homepage next to the application link. Making Changes to the Application: Allow 2-3 weeks after submitting all of the information for processing. Go to and log in to your account using the address provided on the application. Click the I forgot my password link to set up a password. After logging in, click the link for your application and then click the tab that needs to be corrected or updated and move to the next page. The data is saved when you move to the next page. Tax Information: Tax laws vary by country. In the United States, scholarship funds used exclusively for the payment of tuition or textbooks are normally not taxable. You are responsible for taxes, if any, that may be assessed against your scholarship award. We recommend consulting your tax advisor for more guidance. Program Administration To assure complete impartiality in selection of winners and to maintain a high level of professionalism, the program is administered by International Scholarship and Tuition Services, Inc., a firm that specializes in managing sponsored scholarship programs. Questions For additional information regarding the scholarship program contact ISTS by at ContactUs@applyists.com or by phone at (855) When ing, please include Herb Block Scholarship in the subject line. Complete the full application below, then obtain and include copies of the required documents, including your FAFSA Student Aid Report. Unofficial transcripts are acceptable. Mail or your application for this scholarship to: Processing@applyists.com or HERB BLOCK SCHOLARSHIP c/o ISTS 1321 Murfreesboro Road Suite 800 Nashville, TN 37217

3 Herb Block Scholarship Scholarship Application STUDENT INFORMATION (Required for all applicants) First Name Middle Initial Last Name Suffix Permanent Mailing Address Apt. City State Zip Code address (REQUIRED - enter an address you check often) Date of Birth (mm/dd/yyyy) County of Residence Alexandria, VA Falls Church, VA Montgomery County, MD Washington, DC Arlington County, VA Fairfax County, VA Prince George s County, MD Gender (optional) Female Male Home Phone Number (xxx) xxx-xxxx Cell Phone Number (xxx) xxx-xxxx DEMOGRAPHIC INFORMATION (Optional) We are interested in learning more about you and your background so The Herb Block Foundation can better serve the community in Washington DC and the surrounding counties. Country of Origin Is English your first/native language? Yes No Ethnicity African American Asian Caucasian Multi-Racial Native Hawaiian/Pacific Islander Arab/Chaldean Black Caribbean Hispanic/Latino Native American/Alaskan BACKGROUND (Required for all applicants) Please select the statement that most closely applies to you as of today's date. Please provide information for your parents/guardians or spouse (if applicable). I am claimed as a dependent on my parents'/guardians' income tax returns I am legally emancipated/financially independent from my parents/guardians I am the head of my own household Name Relationship to You Occupation/Title Employer s Name Parent Guardian Parent Guardian Spouse Spouse Number of Siblings Sibling Age(s) If you answered I am the head of my own household above: How many people are dependent on your income? Highest Level of Education Some High School High School Diploma/GED Some College Baccalaureate or higher Some High School High School Diploma/GED Some College Baccalaureate or higher ESSAY How has a family member, mentor, or personal experience been influential in your life? Your response must be 500 words or less. Write or type your essay response on a separate page. Include your name, Herb Block Scholarship and Background Essay in the upper left corner of the page, and submit it with the rest of your application packet.

4 ACADEMICS (Required for all applicants) Did you obtain your high school diploma (or your GED/equivalency diploma) prior to July 1, 2007? Yes No If you answered yes, skip to Continuing/Non-Traditional Students below. If you answered no, continue to the next question. Are you applying as a GED or other equivalency diploma holder? Yes No If you answered yes, skip to GED/Equivalency Diploma below. If you answered no, continue to High School. HIGH SCHOOL High School Name City State Are you currently a high school senior? Yes No High School Graduation Date (mm/dd/yyyy) You must provide a copy of your most recent high school transcript for review by the selection committee. Unofficial transcripts are acceptable. Make certain your name is clear and all relevant information is clear on the copy. Write Herb Block Scholarship in the upper left corner of the page and submit it with the rest of your application packet. When you complete this section, skip to Special Courses or Programs. GED/EQUIVALENCY DIPLOMA Date GED or EDP Awarded (mm/dd/yyyy) Students applying with a GED or EDP must provide a copy of the diploma/certificate for review by the selection committee. Make certain your name is clear and all relevant information is clear on the copy. Write Herb Block Scholarship in the upper left corner of the page and submit it with the rest of your application packet. When you complete this section, skip to Special Courses or Programs. CONTINUING/NON-TRADITIONAL STUDENTS In lieu of a high school transcript, please provide a brief statement to the selection committee detailing what you have done since you obtained your high school diploma (or your GED/equivalency diploma) and what has helped you decide to continue your education. Your response must be 1,000 words or less. Write or type your essay response on a separate page. Include your name, Herb Block Scholarship and Continuing/Non-Traditional Student Essay in the upper left corner of the page, and submit it with the rest of your application packet. Continue to Special Courses or Programs. SPECIAL COURSES OR PROGRAMS List special courses or training programs you have taken during the last three years. If you have more items than will fit into the space provided, you may attach a list in the same format as below. Attached lists that do not match the format shown below will not be reviewed. Course or Program Name of School Dates of Attendance COLLEGE (Required for all applicants) Which of the four participating community colleges do you attend/plan to attend? (If you have not finalized your college choice, provide your first choice school.) Community College of the District of Columbia Northern Virginia Community College Montgomery College Prince George s Community College Are you currently enrolled at this college? Yes No If you are currently enrolled at this college, provide your anticipated college graduation date (mm/dd/yyyy) Degree Goal at Community College 2-Year Associate Degree Vocational/Technical Certificate Planned Major/Course of Study Number of credits toward your degree completed at the beginning of the Fall 2014 semester More than 36 As of July 1, 2014, will you have earned an associates or bachelor s degree from a college or university in the United States? Yes No Will you have completed your 40 th credit towards a degree before the start of the Fall 2014 semester? Yes No

5 RESUME Tell us how you ve stayed involved while pursuing your education. Include full names with descriptions rather than acronyms. If you have more items than will fit into the space provided, you may attach a list in the same format as below. Attached lists that do not match the format shown below will not be reviewed. EXTRACURRICULAR ACTIVITIES List activities in which you have participated during the last three years. [Continuing/Non-traditional students are not expected to respond to this section.] (Examples include: school clubs, student government, publications, varsity or club sports, theater arts, scouting) Please define any acronyms. Description Dates of Participation Office/Position Held (indicate if elected or appointed) Awards or Honors SERVICE List community agencies or organizations in which you have participated without pay during the last three years. (Examples include: religious groups, hospital volunteer, cultural activities, outreach programs) Name of Agency or Organization Kind of Activity Dates of Participation Number of Hours Frequency WORK EXPERIENCE List jobs you have held in the last three years, including summer employment. Per Week Per Year Per Week Per Year Per Week Per Year Employer or Type of Business Job or Type of Work Period of Employment Dates of Employment Hours Per Week Full Time Part Time Full Time Part Time Full Time Part Time Summer School Year Summer School Year Summer School Year STATEMENTS please provide a reply to both of the following: If you served as a leader or coordinator in one or more of the activities, groups, or jobs cited above, please choose one, detail your responsibilities and explain the significance of your contribution to the organization. Please describe a life experience you found particularly rewarding or satisfying, and explain why. Experiences can include a course, a job, an activity, an internship, or other life event. Each of your statements must be 500 words or less. Write or type your essay response on a separate page. Include your name, Herb Block Scholarship and Resume Statements in the upper left corner of the page, and submit it with the rest of your application packet. FUTURE GOALS ESSAY (Required for all applicants) Based on your current achievements and interests, describe the kind of work that you plan to be doing in 10 years, both in your career and in your community. Your response must be 1,000 words or less. Write or type your essay response on a separate page. Include your name, Herb Block Scholarship and Future Goals Essay in the upper left corner of the page, and submit it with the rest of your application packet. SUPPLEMENTS (blank forms provided at the end of this document) RECOMMENDATION FORM (required for all applicants) A Recommendation Form can be completed by an academic source, or by a personal contact (not a friend, classmate or family member) familiar with your activities outside the classroom (e.g. extracurricular activities, community service, work experience, etc.) Two (2) completed Recommendation Forms are required to support your application. ACADEMIC EVALUATION (required for current high school seniors only) The Academic Evaluation Form should be completed by your Guidance Counselor or school official who has access to your records and is familiar with your academic performance. One (1) completed Academic Evaluation Form must be submitted to support your application.

6 TERMS and CONDITIONS I understand it is my responsibility to make sure the application process is complete by the required deadline. If not, the application may be disqualified from the awards competition and may not be considered for an award. This application, upon receipt, becomes the property of the program sponsor, and of International Scholarship and Tuition Services, Inc. I agree that, if selected as an award winner for the Herb Block Scholarship, the program sponsor or its agents may use my name and likeness and any other information or materials provided in connection with this program for purposes of news, publicity and advertising in all media, including but not limited to print and electronic media, press releases, internet websites, and video media. To comply with the provisions of the Family Educational Rights and Privacy Act of 1974, I hereby grant permission for school officials to release secondary school records and other requested information, if necessary. If you are under 18, your parent or guardian must also agree to these Terms and Conditions. Student Signature Date Parent/Guardian Signature (if student is under 18 years old) Date APPLICATION CHECKLIST- You may use the following checklist to ensure the application process is complete. All documents must arrive in the same package for the submission to be considered complete. Incomplete applications will not be considered. I have included my complete, signed application. If required, I have included a copy of my high school transcript or GED/EDP diploma. (If possible, include transcripts without watermarks or colored backgrounds; transcripts do not have to be official.) If I am a continuing/non-traditional student, I have included a brief statement detailing what I have done since I obtained my high school diploma (or my GED/equivalency diploma). I have included my college transcript if I have completed any college credit hours. (College students only. If possible, include transcripts without watermarks or colored backgrounds; transcripts do not have to be official.) I have provided all resume information. I have included all requested essay responses. I have included a copy of my FAFSA Student Aid Report (SAR) (The Herb Block Scholarship is a need-based award; students cannot be considered without submitting a FAFSA SAR.) I have included all required Supplement forms. I understand these documents may be scanned and I have not stapled or clipped pages together. I have kept a copy of my entire submission for my records. I am submitting my application prior to the deadline of July 7 (for fall semester consideration) or November 10 (for spring semester consideration). Mail or your application for this scholarship to: Processing@applyists.com or HERB BLOCK SCHOLARSHIP c/o ISTS 1321 Murfreesboro Road Suite 800 Nashville, TN 37217

7 Herb Block Scholarship Recommendation Form Applicant Name Applicant The above named student is applying for the Herb Block Scholarship. One of the requirements to complete this application is to have this form completed by someone who is familiar with their academic performance and/or involvement within their community. Please make special note of the program deadlines: Applications for the fall semester must be complete by July 7 Applications for the spring semester must be complete by November 10 Please complete this form and return it to: Processing@applyists.com or HERB BLOCK SCHOLARSHIP c/o ISTS 1321 Murfreesboro Road Suite 800 Nashville, TN RECOMMENDER CONTACT INFORMATION (Required for all applicants) First Name Last Name Address Institution/Company Phone Number Relationship to Applicant Advisor Community Service Coordinator Family Member Principal Teacher Coach Counselor Friend Religious Leader Other How long have you known the applicant? 0-3 months 4-6 months 7-9 months months 1-2 years 3-4 years 5+ years RECOMMENDATION (Required for all applicants) Please provide evaluations and statements of the topics below based on your experience with the student. Productivity (is attentive/punctual, takes responsibility, consistent quality of work) Outstanding Above Expectations Meets Expectations Below Expectations Teamwork (joins group/team activities, encourages & collaborates with peers) Outstanding Above Expectations Meets Expectations Below Expectations Initiative (motivated to join, eager to participate, demonstrates leadership ability) Outstanding Above Expectations Meets Expectations Below Expectations Overall Rating Outstanding Above Expectations Meets Expectations Below Expectations Productivity Supportive Evidence Teamwork Supportive Evidence Initiative Supportive Evidence Overall Supportive Evidence

8 Herb Block Scholarship Academic Evaluation Form (required for current high school seniors only) Applicant Name Applicant The above named student is applying for the Herb Block Scholarship. One of the requirements to complete this application is to have this form completed by someone with access to the student s academic record and who is familiar with the student s academic progress. Please make special note of the program deadlines: Applications for the fall semester must be complete by July 7 Applications for the spring semester must be complete by November 10 Please complete this form and return it to: Processing@applyists.com or HERB BLOCK SCHOLARSHIP c/o ISTS 1321 Murfreesboro Road Suite 800 Nashville, TN EVALUATOR CONTACT INFORMATION (Required for all high school seniors) First Name Last Name Title Guidance Counselor High School Official College Advisor Phone Number Institution Address ACADEMIC INFORMATION (Required for all high school seniors) Are your school s GPAs weighted or unweighted? Weighted Unweighted What method does your high school use to calculate class rank? 9 th Grade GPA 10 th Grade GPA 11 th Grade GPA 12 th Grade GPA Cumulative GPA GPA Scale Decile Exact Rank in Class GPA Distribution Percentile Quartile Top Percentage of Class Our School Does Not Rank Rank/Percentile/Decile/Quartile Class Size EVALUATION (Required for all high school seniors) Please rate the difficulty of the courses this student has taken and passed. Most Difficult Above Average Average Below Average Based on your knowledge of the applicant, please reply to each of the following statements by selecting the statement that most closely matches your professional opinion of the applicant's capabilities. This student possesses a high level of academic ability. Strongly Agree Agree Neutral Disagree Strongly Disagree This student's academic performance has been exceptional. Strongly Agree Agree Neutral Disagree Strongly Disagree This student is highly involved in extracurricular/co-curricular activities. Strongly Agree Agree Neutral Disagree Strongly Disagree This student has demonstrated excellent leadership ability. Strongly Agree Agree Neutral Disagree Strongly Disagree This student has the self-discipline to excel in a variety of environments. Strongly Agree Agree Neutral Disagree Strongly Disagree This student is highly responsible. Strongly Agree Agree Neutral Disagree Strongly Disagree