1 Student Name: School: Name of Scholarship for which student is applying inside: Brevard Schools Foundation 2015 Scholarship Opportunities Please return this form to your school's guidance office (except where noted) by 5:00 p.m. Wednesday, March 18, 2015 Brevard Schools Foundation 2700 Judge Fran Jamieson Way Viera, FL
2 Dear Graduating Senior, Congratulations on your decision to continue your education beyond high school graduation. Brevard Schools Foundation is offering numerous scholarships to help you achieve your educational goals and dreams. On the following pages you will find a listing of scholarships available through Brevard Schools Foundation, along with any specific criteria required for each scholarship opportunity and/or special instructions. We invite you to apply for as many scholarships as you qualify for by following the instructions found on the 2015 Scholarship Application Form. Please be sure to submit one completed application form for each scholarship you wish to apply for and indicate the name of the scholarship on the front cover of this scholarship booklet. Additional resources for seeking scholarships may be available through your school s guidance office, as well as at the financial aid office of the college or university that you plan to attend. We wish you the best as you pursue these opportunities on your path to a postsecondary degree. Brevard Schools Foundation Scholarship Committee
3 ALL BREVARD PUBLIC HIGH SCHOOLS Amber Stewart Memorial Scholarship (1 scholarship - $600) **Students must be an active school band member and must pursue a degree in Education. Apollo II Scholarship (1 scholarship - $500) **Students must have a minimum 3.0 GPA, must be pursuing a degree in Engineering or other STEM related field and must attend a public or private university in Florida. Students must complete the financial assistance form. Sergeant Anthony Tony Mulqueen Scholarship (1 scholarship - $500, split over two semesters) ** Students must have a minimum 3.0 GPA, and submit one letter of recommendation. Students must exemplify dedication to principles of courage, integrity and faith and clearly demonstrate a history of service to the community. Brevard Schools Foundation Leadership Scholarships (10 scholarships - $500 each) **Students must complete an Eastern Florida State College Foundation STARS online scholarship application only, in order to be considered. Information about the EFSC Foundation scholarship application process and STARS system can be accessed at under Scholarships or by calling the EFSC Foundation at (321) Scholarships are for Eastern Florida State College only and are term specific. Scholarship awards may not be transferred to another post-secondary institution. Brevard Future Teachers Association (1 scholarship - $1,500) **Students must be an active member of his/her school s FEA Club for 2 or more years. Students must have a minimum 2.7 GPA. The recipient must study to teach Science, Math, or Exceptional Student Education (ESE). Students must show community service hours and submit a typed 250 word essay on Why I would like to become a teacher. Buescher Family Scholarship (1 scholarship - $500) **Students must have a minimum 2.5 overall GPA. Students must submit a 200 word typed essay on why continuing their education is important to them. Students must submit 1 letter of recommendation. Students must currently be a student in transition and must complete the financial assistance form. Dr. Thomas W. McIntyre Memorial Scholarship (1 scholarships - $500) **Students must be a varsity scholar athlete, and provide a letter of recommendation from a coach. Applicants must plan to pursue a degree in education or have interest in helping young people in the future. Applicants are preferred to be pursuing a college athletic career in any sport. The applicants must uphold the qualities that Dr. McIntyre upheld himself and instilled in all those he taught and coached; characteristics such as integrity, character and a strong work ethic. The applicants must have a minimum 2.8 GPA and must complete the financial assistance questionnaire form. Finally, applicants must write a typed word essay on How I will uphold the qualities that Dr. McIntyre taught and coached: Integrity, Character and Strong Work Ethic. The GFWC Viera Woman s Club Fine Arts Scholarship (1 scholarship - $1,000 both female and male students may apply.) **Students must live within the GFWC Viera Woman s Club area (Suntree to Pineda, Baytree, Viera, Rockledge east to Indian river and west to St. John s river). Students must plan to major in Theatre, Art or Music. Students must have a minimum 2.5 GPA and be involved in community service. Students must submit 2 letters of recommendation as well as a typed word essay on Based on your background in the Fine Arts, why are you continuing to pursue this area of study? George M. Skurla Scholarship 1 scholarship up to $2,000 each initial scholarship for $500 each with a potential of additional $1500 over 3 additional years) **Students must pursue a career in a Science, Technology, Engineering, Mathematics (STEM) excluding medical field. Students must have a minimum 3.0 GPA, come from a low-income family, and complete the financial assistance questionnaire form. Students must submit a typed 300-word essay expressing long-range life and career goals telling how this scholarship will help them reach their set goals. Students must submit 2 letters of recommendation from a high school teacher, guidance counselor or adult mentor. (These awards will depend upon the recipient maintaining satisfactory grades in a qualifying scholastic program and upon the awarding organization s ability to continue funding the follow on awards.) Grace C. Schultz Scholarships (1 scholarship - $1,500 each) **Students must have a minimum 3.0 unweighted GPA. Students must demonstrate community service hours, maintain an excellent record of behavior in and out of school, participate in leadership roles in or out of school, and provide 2 letters of recommendation. Students must submit a typed 250 word essay outlining career and life goals and why continuing their education is important.
4 Grumman-Northrop Grumman Retiree Club, Space Coast Chapter Scholarship (1 scholarship up to $2,000 each initial scholarship for $500 each with a potential of additional $1500 over 3 additional years) **Students must pursue a career in a Science, Technology, Engineering, Mathematics (STEM) excluding medical field. Students must have a minimum 3.0 GPA, come from a low-income family, and complete the financial assistance questionnaire form. Students must submit a typed 300-word essay expressing long-range life and career goals telling how this scholarship will help them reach their set goals. Students must submit 2 letters of recommendation from a high school teacher, guidance counselor or adult mentor. (These awards will depend upon the recipient maintaining satisfactory grades in a qualifying scholastic program and upon the awarding organization s ability to continue funding the follow on awards.) Jan Simpkins Memorial Scholarship (1 scholarship - $2,500) **Students must be planning to attend medical school and specialize in cancer research and/or treatment. Students must have a minimum 3.75 GPA. Students must submit 2 letters of recommendation. Jeremy Charles Memorial Scholarship (5 scholarships - $500 each) **Students must plan on pursuing a career in law enforcement or criminal justice (excluding attorney) in Brevard County and have at least a 2.75 GPA. These funds can be used for the recipient to attend the Brevard Police Academy at Eastern Florida State College. Myles Freeberg Scholarship (6 scholarships - $1,000 each) **Students must have a weighted 2.5 GPA or better, demonstrate financial need (complete financial assistance form) and provide a letter of recommendation from a teacher or guidance counselor. Students must submit a typed 200 to 250 word essay on the subject What is the importance of friends and how have they impacted your life? Propeller Club Scholarship/Bob Bieske Scholarship (2 scholarships - $1,000 each) **Students must reside in Brevard County, and be a permanent Florida Resident. Applicant must be accepted into an accredited institution in a program related to maritime industry, including a Federal or State Maritime Academy and must have at least a 2.75 GPA. Please submit 3 letters of reference with the application. Ron Jon Surf Shop Scholarship (1 scholarship - $3,000) **Students must have a minimum unweighted GPA of 3.5, must be a Business major (general business, marketing, accounting, etc.), must attend a Florida college or community college, must submit a typed essay expressing their long-range life and career goals and tell how this scholarship will help them reach their set goals. Students must have been involved in a minimum of 4 extracurricular activities during high school and must provide a letter of recommendation from a high school-level teacher or guidance counselor. Space Coast Runners Scholarship (2 scholarships - $1,000 each, 1 male student, 1 female student) **Students must be a member of the high school cross country or track team, or a member of the Space Coast Runners Club. Students must submit a typed 250 word essay on How running has impacted my relationships with community, family or friends. Stephanie Mancilla Leadership Scholarship (1 scholarship - $500) **Students must have overcome some type of obstacle/challenge during his/her life. Tommy Pechacek POW-MIA Memorial Scholarship (1 scholarships - $1,000) **Students must be a member of the ROTC program at their school. Students must have a minimum 2.5 GPA. Students must show involvement in community service and complete the financial assistance form. Students must submit a typed word essay on Why I joined the ROTC USBI Endowed Engineering Scholarship (1 scholarship - $500) **Students must have a minimum 3.0 GPA, must be pursuing a degree in engineering, business, or the teaching of mathematics or science and must attend a public or private university in Florida. Students must complete the financial assistance form. William A. Whitney Scholarship (3 Scholarships-$1,000 each) **Students should have a minimum GPA of 3.25, minimum SAT score of 1575 (or ACT score of 23 or above), and come from a low-income family (complete financial assistance form). Students must attend a 4 year college or university. ASTRONAUT HIGH SCHOOL ONLY Phyllis M. Cullen Memorial Scholarship (1scholarship - $500) **Students must be planning on pursuing an undergraduate degree in, but not limited to, music, education, fine arts, or theatre arts. Students should have a minimum 2.5 GPA, submit 2 letters of recommendation from a teacher/guidance counselor/mentor, and submit a typed 500 word essay describing what impact the arts and/or education have had in his/her life. Essay should also include their goals as a college student and career plans in their respective area of study.
5 COCOA HIGH SCHOOL ONLY Dr. Richard DiPatri Scholarship (1 scholarship - $250) **Students must be a first generation college student. (Please provide parent/guardian level of education in application narrative/statement.) Ned Steel Tiger Pride Scholarship (1 scholarship - $500) **Students must be planning to major in Education, Biology or Life Sciences. Students must have a minimum 2.0 GPA. Students must show financial need and complete the financial assistance form. Students must submit 2 letters of recommendation. COCOA BEACH Jr/Sr HIGH SCHOOL ONLY Alberta and Kenneth Birch Memorial Scholarship (1 scholarship - $1,000) **Students must plan on attending a Florida college or community college (no private colleges permitted) and have a minimum 2.0 GPA. Students must not be enrolled in the CBHS IB program and must currently be employed on a parttime basis. Bob Freeman Surfing Scholarship (1 $1,000 payable over 2 academic years) **Students must be a competitive or recreational surfer. Students must have a minimum 2.0 GPA. Students must complete the financial assistance form and submit a typed 250 word essay entitled What Surfing and Continued Education Mean to Me and 2 letters of recommendation. (Students must be enrolled in an accredited 2 year community college or a 4 year university as a full time student and maintain that status to receive the second year award) Bruce Bernard Memorial Scholarship (1 scholarship - $1,500) **Students must be a scholar athlete and provide a letter of reference from a coach, must have a 3.2 G.P.A. or better, reside within the city of Cocoa Beach, be a citizen of the United States, must come from a low-income family (based on Federal Guidelines complete financial assistance form), and have good attendance and disciplinary records. Dory Schofield Memorial Scholarship (1 scholarship - $500 female student) **Students must submit three letters of recommendation and demonstrate leadership at school or in the community. The ideal candidate would be a female basketball player; the scholarship is open to all female students who fulfill the criteria of the scholarship. Fritz Family Memorial Scholarship (1 scholarship - $1,000) **Students must have a minimum 3.0 GPA, must show community service hours, and must submit one letter of recommendation from a teacher. Students must submit a typed 200 word essay on why it is important to give back to your community. Students must complete the financial assistance form, showing financial need. Kendal A. Stone Memorial Scholarship (1 scholarship - $500) **Student must be pursuing a degree in the medical field or have a significant background in community service. Students must submit a typed 250-word essay on why you have chosen a career in a medical field OR why community service is important AND a letter of recommendation along with application. Myles Freeberg Scholarship (1 scholarship - $1,000) ** Submit under the heading of ALL BREVARD PUBLIC HIGH SCHOOLS Only one application is necessary. Rafe Maccarone CBHS Memorial Soccer Scholarship (2 scholarships - $1,000 each) **Students must be a member of the CBHS Varsity boys or girls soccer team, with a minimum 3.0 GPA, with good conduct and attendance record. Students must submit a typed 200 word essay on Who do you play for and why and a letter of recommendation from a coach, teacher or guidance counselor. EAU GALLIE HIGH SCHOOL ONLY Eau Gallie Women s Club Scholarship (1 scholarship - $1,000 - female student) **Students must have a minimum 2.5 GPA. Students must demonstrate financial need (complete financial assistance form). Students must submit letters of recommendation from 2 teachers, and submit a typed 250 word essay on What does it mean to me to be a woman in today s world? Myles Freeberg Scholarship (1 scholarship - $1,000) ** Submit under the heading of ALL BREVARD PUBLIC HIGH SCHOOLS Only one application is necessary. MELBOURNE HIGH SCHOOL ONLY John Schopke Foundation Memorial Scholarship (2 scholarships - $ male student, 1 female student) **Students must have a minimum 2.5 GPA and have played one or more FHSAA sanctioned sport for at least one season in grades Students must submit a letter of recommendation from a teacher or coach as well as a typed word essay on the topic How have sports enriched my life?
6 MERRITT ISLAND HIGH SCHOOL ONLY Wayne Sparks Memorial Scholarship (1 scholarship - $500) **Student must submit a word essay entitled The Obstacles I ve Had to Overcome to be Successful in School. PALM BAY HIGH SCHOOL ONLY Barbara Duez Brandt Memorial Scholarship (1 scholarship - $1,000) **Students must indicate in the student statement why he/she plans on pursuing a career in Education. ROCKLEDGE HIGH SCHOOL ONLY Henry Jack Kelley Leadership Scholarship (1 scholarship - $500) **Students must submit a typed word essay on how they served in a leadership capacity at school or in a community organization, and 1 letter of recommendation. The Rockledge High School HOSA Club Scholarship (1 scholarships - $500) **Students must have a minimum 2.5 overall GPA. Students must show involvement in community service and complete the financial assistance form. Students must submit a typed essay on Why I have chosen the medical profession and my career goals. Students must submit 3 letters of recommendation. SATELLITE HIGH SCHOOL ONLY The Margaret Wagner Excellence in Music Scholarship (3 $2,000 each 1 for chorus, 1 for band, 1 for orchestra. (Scholarships will be paid over one academic year, two semesters) **Students must have a minimum 3.0 unweighted GPA and a 4.0 GPA in music/chorus classes. Students must have been involved in music programs for a minimum of 3 years. Students must submit a typed word essay on How has music enriched my life? VIERA HIGH SCHOOL ONLY Myles The Wall Freeberg Scholar Athlete Scholarship (1 scholarship - $1000) **Student must be a scholar and a Varsity athlete. Student must have a weighted 3.5 GPA or better and provide a letter of recommendation preferred from a high school or club coach addressing the student s sportsmanship, or teacher or guidance counselor. Student must submit a typed 200 to 250 word essay on the subject What is the importance of friends and how have they impacted your life? or How has participating in your sport or in high school athletics impacted your life? Myles Freeberg Academy Scholarship (1 scholarship - $1000) **Student must be a member of the Academy of Business and Finance or the Academy for Digital Arts & Media. Student must have a 3.0 weighted GPA or better and provide a letter of recommendation from an Academy teacher. Student must submit a typed 200 to 250 word essay on the subject What is the importance of friends and how have they impacted your life? or How has being a member of your Academy impacted your life? Myles The Wall Freeberg Soccer Scholarship (2 scholarships - $500 each) **Student must have been a member of the Boys Varsity Soccer team. Student must have a weighted 2.5 GPA or better and provide a letter of recommendation preferred from a high school or club soccer coach addressing the student s sportsmanship, or teacher or guidance counselor. Student must submit a typed 200 to 250 word essay on the subject What is the importance of friends and how have they impacted your life? or How has participating in your sport or in high school athletics impacted your life? Myles Freeberg Scholarship (1 scholarship - $1000) ** Submit under the heading of ALL BREVARD PUBLIC HIGH SCHOOLS Only one application is necessary. ASTRONAUT, TITUSVILLE AND SPACE COAST JR/SR HIGH SCHOOLS ONLY Janeeta MacMahan Ward Scholarship (1 scholarship - $505) **Student must plan on a major in Elementary Education, have a minimum 3.0 GPA and must submit a typed 200 word essay on the subject Why a person with a loving heart makes a great elementary school teacher. BAYSIDE, HERITAGE, MELBOURNE, WEST SHORE, PALM BAY HIGH SCHOOLS ONLY CERTON s Leadership through Technology Scholarship (2 $1000 each) **Student must pursue a major in technology, have a minimum 3.75 GPA, and have a strong leadership aptitude. Students must submit an updated academic resume and an essay describing future academic goals. In person interviews for those meeting the above requirements will be conducted onsite at the CERTON facility. Students will be alerted of scheduled interview time and location via provided on resume.
7 EAU GALLIE, PALM BAY AND ROCKLEDGE HIGH SCHOOLS ONLY AVID Scholarship (1 scholarship - $500) **Students must demonstrate academic promise, determination and leadership and have been in the AVID program for at least three years. Students must have a 3.0 GPA, a letter of recommendation from a NON-AVID teacher, as well as submit a typed essay titled How have you been influenced by your experience in AVID? MELBOURNE, SATELLITE AND SPACE COAST JR/SR HIGH SCHOOLS ONLY Brugman-Diecidue Family AP Scholarship for Careers in Engineering and/or Mathematics (3 scholarships - $750 each, 1 scholarship per school) **AP Diploma criteria with Calculus AB or AP Calculus BC as the Mathematics credit. Students must take at least 6 full-year AP courses (or a combination of full-year courses and semester courses totaling six full credits), earning scores of 3 or higher on the exams for these courses. All students who meet eligibility requirements will receive a Brevard Public School AP Diploma and the AP Scholarship. (Please see guidance counselor for additional AP course requirement details.) NORTH AND CENTRAL AREA HIGH SCHOOLS ASTRONAUT, COCOA BEACH JR/SR, EDGEWOOD JR/SR, MERRITT ISLAND, SPACE COAST JR/SR, TITUSVILLE, COCOA, EAU GALLIE, ROCKLEDGE, SATELLITE AND VIERA jcares Scholarship (3 scholarships - $1,000 each) **Students must attend a four year university or college, pursue an education in a STEM related field (not medical), and complete the financial assistance form showing financial need. ROCKLEDGE, COCOA, COCOA BEACH JR/SR, HERITAGE, MELBOURNE, BAYSIDE, PALM BAY, TITUSVILLE, ASTRONAUT, SPACE COAST JR/SR, VIERA, EAU GALLIE, SATELLITE and MERRITT ISLAND HIGH SCHOOLS ONLY Nick Catechis Memorial Scholarship (1 scholarship - $1,000) **Must be a SENIOR pitcher on a Cape Coast Conference Varsity Baseball Team at one of the schools listed above. Student must have a minimum unweighted 3.0 GPA; must include a letter of recommendation from team s head varsity coach regarding the player s leadership and sportsmanship abilities as well as his character. The player s on-the-field performance will be considered and factored in when making the final decision on who should be awarded the scholarship. Please furnish us with the following information: Earned Run Average: Wins: Strikeouts: Innings Pitched: Due to the need for the statistics listed above, this scholarship only is due in to the Guidance Counselor by May 1, CENTRAL AREA ADULT EDUCATION ONLY Michael Pope Cheney Scholarship for Adults (1 scholarship - $500) **Students must earn a standard diploma, special diploma or G.E.D. Students must submit 2 letters of recommendation. SOUTH AREA ADULT EDUCATION ONLY Shining Through Shadows Resilient Spirit Scholarship (1 scholarship - $500) **Students must earn a standard diploma, special diploma or G.E.D. Students must submit one letter of recommendation from a teacher or other academic person such as a guidance counselor, and one other letter of recommendation. Students must submit a typed word essay on what character traits make you a resilient spirit. Deadline for scholarship applications: 5:00 p.m. Thursday, March 19, 2015 unless otherwise noted. Return this form with your application to your high school guidance office except where noted.
8 ADDITIONAL SCHOLARSHIPS Courtesy Listings These scholarships are listed as a courtesy only and are not part of the Brevard Schools Foundation scholarship program. Please see each listing and follow specific instructions on how to apply. ALL BREVARD PUBLIC HIGH SCHOOLS The Air Force Technical Applications Center (AFTAC) Company Grade Officer Council (CGOC) at Patrick Air Force Base (1 scholarship - $500) **Applicants must be graduating seniors from Brevard County high schools. Applicant must be entering a Science, Technology, Engineering or Math (STEM) field in a 4 year learning environment and pursuing a STEM college degree. Applicants must have a minimum 3.0 GPA, list all community and school involvement, such as community service performed, school organizations the applicant is a member/leader of, etc. Applicants must fill out the application form and write a 1-2 page essay in response to a STEM-related question proposed by the Scholarship Chairperson. Applicant must include a copy of their college/university s acceptance letter. Applicants must postmark the application no later than April, For more information and to receive the application form, contact David Friday, 1st Lt, USAF, STEM Scholarship Chair (321) or BASA/A Scholarship (Number of scholarships / dollar amounts vary) **Student must have at least a 2.5 GPA; only one applicant per school based on principal s recommendation. Among those receiving BASA/A scholarships, one distinguished recipient will be identified as receiving the Marge Ebersbach Scholarship. Please submit this application to your school s guidance counselor and not directly to the Brevard Schools Foundation. BASA/A Daniel T. Scheuerer Scholarship (Number of scholarships / dollar amounts vary) **Student must have at least a 2.5 GPA; one parent must be a member of BASA/A. Please submit this application directly to Dr. Richard Dunkel, Principal, Indialantic Elementary and not your school s guidance counselor. Balda Family Foundation (multiple scholarships - range $1,000-$3,500) Student must meet the following criteria: Brevard County resident, 2.8 GPA or higher, must show financial need, currently attending or accepted at a post-secondary, technical or vocational institution. Applications are accepted from February 15th through April 15th. For the application and more information visit, or Do not use the enclosed application. THE BEECHER WHISENANT SCHOLARSHIP (1 scholarship - $1000, 1 scholarship - $500) **The student must have a minimum 2.5 GPA or score a minimum of 1200 on the SAT or 13 on the ACT. An official transcript must be provided. Student must show proof of acceptance at an accredited post-secondary, technical, or vocational institution. Student must show evidence of participation in community, church or governmental projects. Student must submit a 500 word or less essay describing career goals, including where applicant intends to pursue his/her career and how this award will assist in obtaining that goal. Student must submit a letter of recommendation from one of the following: guidance counselor, high school principal, teacher, clergy, business or professional person known to you. Deadline for application is May 15, Submit all applications to: Beecher Whisenant Scholarship Committee, P. O. Box , Rockledge, FL The NASA College Scholarship Fund Inc. is a nonprofit organization that awards undergraduate scholarships to NASA dependents pursuing a course of study in science or engineering fields. Up to five scholarships will be awarded this year. Information on the guidelines for applying for the scholarship can be found online at Applications are being accepted and must be received by the corporation scholarship committee at JSC no later than March 31, POC: Patricia Gillis or Phoenix Song Scholarship (multiple scholarships between $1000 and $33,000 per year) Students must have a 3.5GPA and be applying to a four-year university and pursuing an education in musical instrumental performance, vocal performance, or some aspect of stagecraft. If you have questions, would like more information, or want to download the application, please visit Phoenixfoundationcfl.org. Phoenix Flight Scholarship (multiple scholarships between $1000 and $33,000 per year) Students must have a 3.5GPA and be applying to a four-year university and currently active in an organization that supports the promotion and education of LGBT (Lesbian, Gay, Bisexual and Transgender) causes. If you have questions, would like more information, or want to download the application, please visit Phoenixfoundationcfl.org. Phoenix Flame Scholarships (multiple scholarships between $1000 and $33,000 per year) Students must have a 3.5GPA and be applying to a four-year university and who have had either one or both of their parents die. If you have questions, would like more information, or want to download the application, please visit Phoenixfoundationcfl.org.
9 Space Coast Women in Defense (3 awards - $ each) **Student must be a female high school senior, undergraduate or graduate student currently enrolled/accepted in a regionally accredited Florida university or college, either full or part time, a Florida resident, interested in pursuing a career related to national security, defense or a STEM related field, demonstrate financial need, have a minimum 3.0 GPA and show proof of citizenship. The deadline for applications is April 15, See for application and additional information. Do not use the enclosed application. Wuesthoff Auxiliary Scholarships **Wuesthoff Auxiliary scholarship applications for the 2015/2016 college year are now available. Study must be for an undergraduate degree (two or four year) in a human medically-related field. Applicant must be a resident of Brevard County, be a full-time student, and maintain a 3.0 academic average or above. To download the application, go to: All applications must be received by March 23, For questions, please call (321) LIMITED TO MELBOURNE, PALM BAY, EAU GALLIE AND WEST SHORE JR/SR HIGH SCHOOLS Judge Richard & Marie Muldrew Memorial Scholarship sponsored by St. Paul Lutheran Church (2 awards - $1,000 each) **Student must have a minimum 2.0 GPA. It is often said that you should never judge another person until you walk in his or her shoes. Student must submit a word essay telling about an experience that enabled him/her to better understand another person. Essay to include a title page or cover sheet, and should be typed and single-spaced using a customary 12- point font. Submit essay and enclosed application to: ST. PAUL LUTHERAN CHURCH, SCHOLARSHIP ESSAY, 105 W. HIBISCUS BOULEVARD, MELBOURNE, FL
10 Brevard Schools Foundation 2015 Scholarship Application Form TO THE APPLICANT: READ ALL INSTRUCTIONS BEFORE YOU BEGIN. Please complete this application so we can determine your eligibility for receiving scholarship funds for pursuing your postsecondary education through the assistance of the Brevard Schools Foundation. Complete this application as soon as possible; then forward the application to the person you have selected to complete the appraisal. You are encouraged to select a teacher or adult mentor. You may also select an employer, clergy member, job supervisor, or any other person who is in a position to evaluate you according to the criteria given. Family and relatives are excluded. Return the completed form along with your evaluation to your guidance counselor. PLEASE USE THE APPLICATION ATTACHED. If any questions are not applicable to your current situation, please so note on the application by answering N/A. If completing on a computer, use a minimum of Times Roman 10 point font. Provide answers to narrative questions on typewritten attached pages using a minimum of Times Roman 10 point font. Do not leave any space blank. Selection will be made by a selection committee based upon the scholarship criteria and student qualifications, without discrimination because of race, color, religion, sex, age, national origin, disability or any other protected characteristic as established by law. Students may apply for more than one scholarship; however a completed application with original signatures in blue ink is required for each scholarship application. You are responsible for seeing that all supporting documents are submitted and the criteria for each scholarship you submit are met. The Brevard Schools Foundation reserves the right to process only applications found to be eligible by the guidelines and fully completed as of the deadline. Applications must be submitted to your guidance counselor by 5:00 p.m. Wednesday, March 18, 2015 unless otherwise indicated. REMEMBER: This application becomes valid only when a high school transcript has been submitted. If selected for a scholarship, it is your responsibility to ensure your transcript is sent to Brevard Schools Foundation. CERTIFICATION In submitting this application, I certify the information provided is complete and accurate to the best of my knowledge. Falsification of information may result in termination of any scholarship granted. Acceptance of a Brevard Schools Foundation Scholarship grants permission for the promotion and publication of your award and constitutes your guarantee that funds will be spent on legitimate college expenses. Scholarships are not renewable. Students are responsible for having their college/university request funds after the student has enrolled. Funds not requested by June 15, 2017 will be forfeited, unless otherwise noted. EACH SCHOLARSHIP APPLICATION MUST HAVE ORIGINAL SIGNATURES IN BLUE INK BELOW. Applicant s Signature Date Parent/Guardian Signature Date Guidance Counselor Signature Date
11 PLEASE PRINT OR TYPE APPLICANT DATA Mr. XXX-XX (last 4 digits) Ms. Name (Last) (First) (MI) Social Security Number Permanent Address (Street) (City) (State) (Zip) Date of Birth (month, day, year) Telephone Number Address Name of parent/guardian Permanent mailing address of parent/ Guardian if different from applicant (Street) (City) (State) (Zip) Telephone Number SCHOOL DATA High School Attended Graduation Date: Month Year Address (Street) (City) (State) (Zip) Telephone Number Name of High School Principal Name of post-secondary school for which applicant s scholarship is requested 4-year College/University Vo-Tech Community College Other Accredited? Yes No Address (City) (State) (Zip) Student will: Live on campus Live off campus Commute Enrolled: Less than half-time Half-time or more Full-time (12 credit hours or more) Anticipated date of graduation from postsecondary program (month) (year) Major Field of study applicant plans to pursue OTHER AWARDS Please list below the names and amounts of any grants or scholarships that you have been awarded for college, including any Bright Futures scholarship that you are eligible to receive. Name of Award Amount Granted Pending If you are not receiving a Bright Futures scholarship, please indicate the reason below:
12 PERSONAL DATA Describe your work experience during the past 4 years. Indicate dates of employment in each job and approximate number of hours worked each week. List total amounts earned at each job. Position Date From (mo/yr) Date To (mo/yr) Hours per Week Amount Earned List all school activities in which you have participated during the past 4 years (e.g., student government, music, sports, etc.) List all community activities in which you have participated without pay during the past 4 years (e.g., Red Cross, church work, and volunteer work). Indicate all special awards and honors. Use an additional sheet if necessary. School Activity No. of Years Partic. Special Awards, Honors, Offices Held Community Activity No. of Years Partic. Special Awards, Honors, Offices Held NARRATIVE/STUDENT STATEMENTS A. Make a statement of your plans as they relate to your educational and career objectives and future goals. Please use a typed separate page. B. Please describe how and when any unusual family or personal circumstances have affected your achievement in school, work experience, or your participation in school and community activities. Please use a typed separate page.
13 APPLICANT APPRAISAL (REQUIRED) To be completed by an instructor, a supervisor, or adult mentor. You have been asked to provide information in support of this application for scholarship. Please give immediate and serious attention to the following instructions. When complete, please return to applicant or photocopy this section and return to applicant in a sealed envelope. The applicant s choice of a postsecondary extremely very moderately inappropriate education program is appropriate appropriate appropriate The applicant s achievements reflect extremely very well moderately not well his/her ability well well The applicant s ability to set realistic and excellent good fair poor attainable goals is The quality of the applicant s commitment excellent good fair poor to school and community is The applicant is able to seek, find, and use extremely very well moderately not well learning resources well well The applicant demonstrates curiosity and extremely very well moderately not well Initiative well well The applicant demonstrates good problem- extremely very well moderately not well Solving skills, follow through, and completes tasks well well The applicant s respect for self and others is excellent good fair poor Comments Appraiser s Signature Date Title Telephone Number Appraiser s Business Address (Street) (City) (State) (Zip) TRANSCRIPT INFORMATION High school seniors must include a high school transcript of grades and have the following section completed by the appropriate school official. Applicant ranks in class of Cumulative grade point average /4.0 scale PSAT Reading Writing Math SAT Reading Writing Math ACT Standard English Math School Official s Signature Date Title Telephone Number School Address (Street) (City) (State) (Zip) Application Checklist Application This application for student aid becomes complete only All required signatures IN BLUE INK When you have returned the following materials Current Transcript of Grades Application Deadline: 5:00 PM, Wednesday, March 18, 2015 except for the Nick Catechis Scholarship due May 1, 2015 Return application to your high school counselor! (except where noted)
14 FINANCIAL ASSISTANCE QUESTIONNAIRE (FAQ) For school year To be completed ONLY for those scholarships based on financial need *See next page for instructions to assist in completing this form A. STUDENT Mr. Ms. Last Name First Name Middle Initial Student ID Number Permanent Mailing Address Street Apartment # City State Zip Daytime Phone Number B. PARENTS /LEGAL GUARDIAN S INCOME, EXPENSE, AND ASSET DATA (FOR THE YEAR JANUARY 1, 2014 TO DECEMBER 31, 2014). The applicant s parent(s)/legal guardian must complete the following section. NOTE: If legally classified as an independent student, use this section to supply your (and your spouse s, if any) financial information. Indicate whether the information is from: Estimates based on current income information to be filed by April 15, 2015 A completed tax return IRS FORM 1040 filing date of April 15, Adjusted gross income (FORM 1040) $ 2. Total federal tax paid (FORM 1040).. $ 3. Total income of father or self if independent student. $ Yearly income of mother $ 4. Yearly untaxed income and benefits: Social Security, AFDC, child support, other.. $ 5. Medical/Dental expenses not paid by insurance (exclude premiums). $ 6. Total cash, checking, savings, cash value of stocks, etc. (exclude retirement. $ plan funds, IRA, 401 (K) 7. Total number of family members living in the household and primarily supported by the reported income $ C. ADDITIONAL INFORMATION Parents /legal guardian s or independent student s current marital status is: single married separated divorced widowed Total number of family members who will be attending a post-secondary school at least ½ time during the school year, including applicant...# D. CERTIFICATES AND SIGNATURES (in blue ink) CERTIFICATION: All information on this form is true and complete to the best of my (our) knowledge. If asked by any authorized official of BSF, I (we) agree to give proof of the information that I (we) have given on this form. I (we) realize that this proof may include a copy of my (our) 2014 U.S. income tax return. I (we) also realize that if I (we) do not give proof when asked, the student may not get the scholarship. Applicant s Signature Parent s Signature (blue ink) Father Mother (Not required for independent student) Do you have legal custody of the student? Yes NO Is the student your dependent? Yes No Date Completed
15 INSTRUCTIONS FOR COMPLETING THE FINANCIAL ASSISTANCE QUESTIONNAIRE (FAQ) A. APPLICANT INFORMATION: The scholarship applicant s name should appear on the first line in the FAQ; however, the questionnaire must be completed by the parents of the applicant. An exception is if the applicant is legally classified as an independent student. The independent student must supply his/her financial information. B. PARENTS INCOME, EXPENSE AND ASSET DATA: Information on this form must be from the parents /legal guardian s completed tax return or based on estimated information to be filed by April 15, Be sure to check the appropriate box. 1. Adjusted Gross Income can be found on IRS FORM 1040 and is gross income reduced by specific adjustments allowed by law. 2. Total Federal Tax Paid includes the total amount of federal income tax to be paid as reported on IRS FORM This is not the amount withheld from employee paychecks. (The amount withheld should be adjusted by any refund or additional taxes due.) Do not report state income tax. 3. Total Income earned should be reported individually for both parents. If the student resides with only one parent, Brevard Schools Foundation prefers to receive financial information from both natural parents, when possible. Financial information must be received from the parent who claims the child as a dependent for tax purposes. If a parent has remarried, the spouse s information is required if the spouse is a legal guardian of the student, or claims the student as a dependent, or the student is included in the spouse s benefit plan. If necessary, two Financial Data sections may be submitted by the student. A copy of the Financial Data section may be made in order for one to be completed by each parent. 4. Untaxed Income and Benefits include any other income or benefits not included in the adjusted gross income figure. Do not include untaxed contributions to retirement plans. 5. Medical and Dental Expenses include only those expenses not paid by insurance. Do not include premium payments. 6. Total cash, checking, savings, cash value of stocks, etc. include liquid assets that can be used for educational expenses. NOT included are IRA, 401K, or other retirement plan funds. 7. Total number of family members living in the household and primarily supported by the above income includes dependent college students living away from home. C. ADDITIONAL INFORMATION: Be sure to check the appropriate box giving the current marital status of the persons for whom financial information is being submitted. Include the total number of all family members attending post-secondary school at least half time. (Post-secondary school includes any two or four-year college or vocational school.) Be sure to include the applicant in this number. D. CERTIFICATION AND SIGNATURES: This form must be signed by both the student and the parent completing the FAQ. Parents signature is not required for an independent student. Please read the certification. NOTE: Any exceptions to providing financial information as instructed above must be submitted to Brevard Schools Foundation in writing.
16 Brevard Schools Foundation Board of Directors Yvonne McGuire-Ingram, Wells Fargo Bank President Anthony Munroe, The Pepsi Bottling Group Vice-President A. Thomas Hollingsworth, Ph.D., Management Consultants, LLC Treasurer Erika Lemp, CareerSource Brevard Secretary Kim Botelho, 2012 Brevard County Teacher of the Year Ryan Brandt, Brandt Ronat & Co. David O. Brock, Community Credit Union Jim Clamons Harris Corporation John Clark Skanska USA John Craig School Board Member Meredith Gibson Community Credit Union Frank Huston Artemis Judith John, Community Leader Glad Kurian Morgan Stanley Mike LaFortune Product Strategy and Business Development Patty Martin, Community Volunteer Dean H. Stewart, Dean Stewart Photography Leslie Straus-Fowler, Community Leader J. Mason Williams, GrayRobinson, P. A. Established in 1987, the Brevard Schools Foundation is a 501 (c) (3) non-profit organization supporting Brevard Public Schools. Funds raised by the Foundation supplement dollars available through the school district to provide for special projects not supported through existing budgets & programs. The Foundation s signature programs are: Take Stock in Children Supply Zone for Teachers Teacher classroom grants Scholarships for graduating seniors Space Week Recognition Events The opportunity to impact the future of our children begins with the actions we take today. Brevard Schools Foundation 2700 Judge Fran Jamieson Way Viera, FL (321) ext. 756
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