COLLIN COUNTY A&M MOTHER S CLUB SCHOLARSHIP INFORMATION AND APPLICATION FORM

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1 COLLIN COUNTY A&M MOTHER S CLUB SCHOLARSHIP INFORMATION AND APPLICATION FORM AMOUNT: $1, SCHOLARSHIPS Scholarships will be awarded to freshman or transfer students and returning A&M students. The scholarship selection committee chooses the scholarship recipients. Each scholarship is paid directly to Texas A&M University, deducted from the fee statement at onehalf of the scholarship amount per semester. ELIGIBILITY The student must reside in Collin County OR have graduated from a Collin County high school OR be an immediate family member of a Collin County A&M Mother s Club member to be eligible. Any Collin County High School Senior or College Transfer accepted as a full time student (12 hours) to Texas A&M University-College Station, Galveston or Health Science Center for the upcoming fall semester 2016 may apply. Any student currently enrolled at Texas A&M University-College Station, Galveston or Health Science Center with a GPA of at least 2.5 may apply for a scholarship to be disbursed in the upcoming fall & spring semester. If you have already received a CCAM scholarship, you may not reapply. APPLICANTS MUST NOT BE A RECIPIENT OF A PREVIOUS SCHOLARSHIP FROM PLANO OR COLLIN COUNTY A&M MOTHERS CLUB. REQUIREMENT LIST 1. Fill in application completely. Please type or use black ink. If additional space is needed for activities, honors and awards, or financial information, attach another sheet to the application. 2. Attach a one-page ONLY paper stating your reasons for choosing Texas A&M and why you need/want a scholarship from the Mother s Club. 3. Submit an official college or high school transcript. If a high school student, an official transcript must include SAT/ACT scores. If not on transcript, please provide a letter from your high school counselor or an official copy of your scores from the testing agency. *College Transfers and Returning Texas A&M students do Not need to submit high school transcripts. 4. Return the completed application, your one page paper and official transcript, POSTMARKED by March 31, 2016 to: Collin County A&M Mothers Club c/o Beth Usnick 4221 Dottie Drive Plano, TX Incomplete packets cannot be considered. If you overnight your package, please write no signature required on envelope. Collin County A&M Mothers Club Scholarship Committee Co-chairs & Applications available online: ALL SCHOLARSHIP APPLICATIONS ARE REVIEWED ANONYMOUSLY BY THE SCHOLARSHIP COMMITTEE.

2 Texas A&M University, College Station Collin County A&M Mother s Club Scholarship Application Date: PERSONAL INFORMATION Name: Address: City State Zip Home Phone: address: Cell Phone: Parents Name: Siblings/Ages: U.S. Citizen: YES NO Father/Guardian Name: If not: Permanent Resident? Obtaining Citizenship? Mother/Guardian Name: Address: Address: Address: Address: Page 1

3 EDUCATIONAL RECORD (Entering Freshmen ONLY Complete This Section) Present High School: Graduation Date: SAT Score: ACT Score: High School GPA: Class Rank: Class Size: Tentative College Major: (Current A&M and Transfer Students ONLY Complete This Section) Cumulative GPA: Class of: Date Entered College Expected Graduation Date: Major: Expected Degree: UIN/ID number: Street / P. O. Box: City / State / Zip Code: Phone Number: College Address: Please indicate which campus you will be/are attending. TAMU College Station TAMU Galveston TAMU Health Science Center Page 2

4 Please list 3 school and/or community extra-curricular activities. Entering freshmen include activities from grades Current A&M students and College Transfer students include college activities only. Grade: Activity or Organization: Office and/or Duties: In what organization were you most active and what was your role within the organization? What did you accomplish and what did you find most rewarding in this organization? Page 3

5 What are your goals for the next 4 years, both academic and extra-curricular? What do you plan to contribute to A&M (service, leadership, and spirit)? List Honors and/or Awards: List any work experience including summer and part-time employment you have had during high school or college: Position: Employer: Dates Employed: Hrs/Week: Total Earnings: Page 4

6 FINANCIAL INFORMATION THIS INFORMATION IS STRICTLY CONFIDENTIAL. The committee reviewing these applications will not know the identity of the applicant. Names, addresses, phone numbers, etc. will be blacked out before the applications are given to the committees. Because this scholarship is partially based upon financial need, the following information will help the scholarship committee assess your financial situation. List any scholarships, grants that have been or will be awarded to you for the coming academic year. Name: Amount per year Current and/or Future: Father s Occupation/Employer: Mother s Occupation/Employer: Family Income Range: Under 19,999 20,000 39,999 40,000 59,999 (as reported on IRS form) 60,000 75,999 76,000-99, , ,999 over150,000 Total Family Size: Number of students in college next year with enrollment of 12 or more hours (including yourself): Are there any persons, other than your parents, siblings and yourself, who receive financial support from your family? Please list any additional information that would be helpful in assessing your need for this scholarship. Page 5

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