Patterson Mill High School Athletic Boosters Scholarship Application Instructions

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1 Patterson Mill High School Athletic Boosters Scholarship Application Instructions General Information 1. This application is to be used by a graduating, class of 2010, high school senior who will begin studies at an accredited post-secondary institution or educational training program in the fall of The student must have participated for at least one complete season as an athlete or manager of a Patterson Mill High School varsity team and must have been enrolled at Patterson Mill High School for at least four semesters prior to graduation. 2. The applicant is responsible for gathering and submitting all necessary information, signatures and official documents. Applications are evaluated on the information supplied; therefore, answer all questions completely. Give specific dates when required. 3. The Patterson Mill Athletic Boosters Scholarship Committee reviews and determines applicant eligibility criteria. Family members of the Patterson Mill Athletic Boosters Scholarship Committee are not eligible to apply for the scholarship. 4. The Patterson Mill Athletic Boosters Scholarship Committee determines selection criteria. Criteria may include all or some of the following: academic achievement, athletic participation, essay, leadership, honors, community service, and work experience. Financial need is not taken into consideration. 5. The Patterson Mill Athletic Boosters Executive Board determines the number of scholarships to be awarded and the monetary value of each scholarship based on available funds, the number of applicants, and the analysis of scores. Submission of an application does not guarantee a scholarship. 6. Awards are granted without regard to race, gender, ethnicity, religion, or disability. 7. The committee invites persons from the community to judge the essays. Family members of essay judges are not eligible to apply for the scholarship. 8. All documents submitted to the Patterson Mill Athletic Boosters Scholarship Committee become its property. Documents will not be released to applicants nor will they be forwarded to other institutions or agencies. 9. Scholarship awards will be presented at the Patterson Mill High School Senior Awards Assembly. 10. Direct all inquiries to the Patterson Mill Athletic Boosters Scholarship Committee Chairperson. Telephone: (410) annie_brock-scholarship@pmathleticboosters.org

2 Eligibility The applicant: 1. Is a high school senior, graduating from Patterson Mill High School in Possesses a cumulative grade point average (GPA) of 3.25 or better (based on a 4.0 scale). 3. Has participated for at least one complete season as an athlete or manager of a Patterson Mill High School varsity team. 4. Will have attended Patterson Mill High School for at least four semesters prior to graduation. 5. Is eligible for participation in school activities at the time of application. 6. Has been accepted at an accredited post-secondary institution or educational training program. 7. The applicant, or the applicant s immediate family, must be a member of the Patterson Mill Athletic Boosters by December 1, Limitations 1. Scholarship funds are to be used within the academic year. 2. Scholarship funds awarded are to be used for tuition, fees, and books, but may not be used for housing, room or board. 3. Payment of scholarship awards will be made directly to the selected school or educational training program. The recipient must provide the Scholarship Committee with the name and address of the school the recipient will attend fall term. If this information is not received by July 31, 2010, the award will be considered unclaimed and will be rolled back into the Patterson Mill Athletic Boosters Scholarship Fund. 4. If the student withdraws from their program of study prior to the funds being exhausted, the remaining funds must be returned to the Patterson Mill Athletic Boosters Scholarship Committee as soon as possible.

3 Application Completion Print legibly in black ink or type, using only available spaces on the form. If additional space is required, continue on 8½ x 11 white bond paper, properly titled. The instructions must be followed or the applicant may be penalized points, for not doing so, in the evaluation process. (Note: Sections requiring Total Hours do not mean the number of hours per week or month. Enter total hours completed/served.) Do not attach a resume. This application becomes complete and valid only when all of the pages listed below are delivered. Do not staple the pages of the application together. All materials must be submitted at the same time. Paperclip the application together in the following prescribed order: 1. Personal Data 2. Two (2) copies of the following : Educational Information Employment Community Service High School Activities/Awards & Honors High School Athletic Participation 3. Two (2) copies of the Essay written by the applicant. The student will submit an essay of words in length; typed on 8½ x 11 white bond paper, double-spaced. Give your reflection of your participation in high school athletics and how you will use that experience as you enter into post-secondary education and beyond. DO NOT use your name, sport, or other identifiers in the essay. 4. Official transcripts, which support all educational data and documenting the GPA (NOTE: Grade reports and copies of transcripts are not acceptable.) 5. Certification Letter Application Delivery Instructions The completed application, with the designated copies and all required signatures, must be delivered to the Patterson Mill High School Guidance office by 3:00pm on April 9, 2010.

4 APPLICANT INFORMATION NAME (Last, First, Middle) Home Address Home Phone Number City/ST ZIP address PARENT/LEGAL GUARDIAN INFORMATION Parents /Legal Guardians Name Home Address Home Phone Number City/ST ZIP address

5 EDUCATIONAL INFORMATION High Schools attended - Grades 9-12 (Name, City, ST) GPA Dates Attended From Mo/Yr To Mo/Yr GPA PMHS HIGH COUNSELOR Please complete the following and attach complete high school transcript. Counselor s Signature: Date: Name of accredited post-secondary institution or educational training program you will most likely attend in the fall of 2010:

6 EMPLOYMENT (August 2006 Present) List most recent employment first; including expected employment hours through 1 April Total Dates employed Employer (Name, City, ST) Position/Title Hours From Mo/Yr To Mo/Yr

7 COMMUNITY SERVICE (August Present) List volunteer work with unit, school, service, religious, and other community organizations. List most recent service first. Total Dates of service Organization (Name, City, ST) Position/Title Hours From Mo/Yr To Mo/Yr

8 HIGH SCHOOL ACTIVITIES (Non-Athletic) List activity and place the descriptive symbol in the appropriate grade column P-President T-Treasurer M-Member VP-Vice-President S-Secretary O- Please state position Activity 12 TH 11 TH 10 TH 9 TH Description e.g., Drama Club P T M M 11 th Lead role in Dracula AWARDS & HONORS, Grades 9-12 Begin with the most recent; include county & above athletic awards. Award/Honor and Organization Description Grade e.g., PTSA Reflections Program Photography 1 st Place, Ramstein HS Won first place in school level competition 12th

9 HIGH SCHOOL ATHLETIC PARTICIPATION 9th Grade V/JV Leadership Position If you did not complete the season, please specify the reason. 10th Grade V/JV Leadership Position If you did not complete the season, please specify the reason. 11th Grade V/JV Leadership Position If you did not complete the season, please specify the reason. 12th Grade V/JV Leadership Position If you did not complete the season, please specify the reason. Signature: PMHS ATHLETIC DIRECTOR CERTIFICATION Please certify that the information provided on this page is correct. Date:

10 CERTIFICATION LETTER If I accept a Patterson Mill Athletic Booster Scholarship, I certify I will abide by the following conditions: 1. Scholarship funds are to be used within the academic year. 2. Scholarship funds awarded are to be used for tuition, fees, and books at an accredited post-secondary institution or educational training program. Funds may not be used for housing, room, or board. 3. Payment of scholarship awards will be made directly to the selected school. The recipient must provide the Scholarship Committee with the name and address of the school the recipient will attend fall term. If this information is not received by July 31, 2010, the award will be considered unclaimed and will be rolled back into the Patterson Mill Athletic Booster Scholarship Fund. 4. The scholarship award, when combined with other scholarships, must not exceed the cost of tuition, fees, and books for the academic year. Any remaining funds must be returned to the Patterson Mill Athletic Booster Scholarship Committee as soon as possible. 5. If I withdraw from my program of study prior to the funds being exhausted, the remaining funds must be returned to the Patterson Mill Athletic Booster Scholarship Committee as soon as possible. 6. I am a responsible citizen in good standing in the school and the community. 7. It is my responsibility to notify the Patterson Mill Athletic Booster Scholarship Committee of any change of status (e.g., change of schools, change in address, etc.) Failure to do so may result in the forfeiture of my scholarship award. 8. Unclaimed funds as of July 31, 2010 revert to the Patterson Mill Athletic Booster Scholarship Fund. 9. If any of the above conditions are violated, scholarship funds must be returned to the Patterson Mill Athletic Booster Scholarship Committee fund. I agree that my signature on this form will authorize the Patterson Mill Athletic Booster Scholarship Chairperson to release this application, including social security number, GPA, and transcript(s) to the Patterson Mill Athletic Booster Scholarship Committee and Patterson Mill Athletic Booster Scholarship Selection Committee as needed. I certify that all information in this application is accurate to the best of my knowledge and the essay is entirely my own effort. APPLICANT S NAME Printed Signature Date PARENT/LEGAL GUARDIAN S NAME Printed Signature Date

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