Scholarship Application

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1 Scholarship Application Contact: Renée Bromfield, Director of Community Relations, at or call at Making A Difference Scholarship DEADLINE for scholarship applications is Friday, April 24, 2015 at 5:00 p.m. (NO EXCEPTIONS) 2. Refer to the application process below for a list of the supporting documents needed: i.e., reference forms, evidence of GPA, etc. Incomplete applications are not considered. 3. If any question does not apply to you, please put N/A in the space provided. 4. Type or print legibly. All illegible applications are returned. 5. Applicants are notified by phone or in April regarding the status of their application. 6. If you have any questions about the application process, please call Renee Bromfield, Director of Community Relations. She may be reached by phone at (704) or by at PURPOSE The Bethlehem Center of Charlotte Scholarship Fund was established in The mission of the scholarship is to provide financial assistance to incoming freshman enrolled for undergraduate study in a college, trade school or university. The Bethlehem Center Scholarship principally targets two and four year academic programs; however, certificate/licensing programs including but not limited to fields such as paralegal training, IT, ultrasound techs, medical records personnel and nursing programs are also eligible. FINANCIAL ASSISTANCE is based on financial need, academic performance, leadership potential and participation in Bethlehem Center programs including but not limited to volunteer hours. Scholarships are awarded and/or renewed annually provided funds are available. In addition, the scholarship may be renewed provided the award recipient meets the conditions outlined below in Scholarship Renewal. SCHOLARSHIP AWARDS The Bethlehem Center of Charlotte awards scholarships to upcoming freshman only on the basis of a comprehensive process. Areas reviewed by the committee include, but are not limited to the following: Academic Accomplishments, Community Service, References, Personal Essay and Financial Need. Bethlehem Center pays scholarship funds directly to the recipient s school. Scholarships are awarded each semester and are continued each semester if the student maintains a 2.5 GPA each semester. Bethlehem Center Scholarships are awarded without regard to race, color, ethnicity, gender or sexual orientation. Fund availability and additional criteria are also considered when awarding scholarship funds. CRITERIA Applicants must have permanent residence status in Mecklenburg County, North Carolina. Applicants must attend or have completed high school successfully with a minimum unweighted GPA of 2.5 on a 4.0 academic scale. Applicants must be a full time student at a college, university, or trade school program for the upcoming academic semester, fall If scholarship money is awarded, funds are sent directly to the institution on behalf of the applicant. 1

2 CRITERIA continued Applicants must demonstrate a need for financial assistance, for example a parent s tax return. Preference may be given to applicants who have participated in Bethlehem Center programs. Applicants must be a citizen or legal permanent resident of the United States. Student must apply for the Federal Student Aid Application (FAFSA). Student must submit a copy of their Student Aid Report (SAR). Applicants must complete and submit a Scholarship Application by Friday, April 24, Scholarship recipients will receive their check for the second semester only after their grades from the previous semester are received. Both new and renewal applications are due Friday, April 24, Candidates eligible for interviews are notified by Bethlehem Center in April or May Applicants are notified if awarded a scholarship in May or June Application Process NEW SCHOLARSHIP APPLICANTS MUST PROVIDE: Completed application form. Official high school transcript in a sealed envelope from the institution. Two academic references from a guidance counselor or teacher. A letter completed reference from an employer or other community member not related to the applicant. Proof of acceptance at an academic, vocational or technical school for post-secondary studies. Demonstrated financial need. (Parent s tax return.) SCHOLARSHIP RENEWAL APPLICANTS MUST PROVIDE: Scholarships may be renewed annually if entering a full time program, and up to three times for a total of four years of study, if recipients maintain a 2.5 average GPA and complete required volunteer hours. More than three renewals may be considered on a case by case basis. This presupposes that funds are available for disbursement. The scholarship recipient must demonstrate need for continued financial assistance. A personal statement/paragraph describing their experience during the academic year, what they learned, challenges they encountered and what they intended to do the following year to help them move forward in life. Completed application form excluding items numbered 4 and 10. The scholarship recipient must retain permanent residence status in Mecklenburg County, North Carolina. Students must provide a transcript for consideration. Students may provide a transcript printed from an online college record through the prior semester or an official transcript. Awards are made provisionally pending receipt of final grades from spring semester of that year. Renewal applications are due by Friday, April 24, SCHOLARSHIP AWARDS Applicants will receive award notification by mid-may or June Applicant must provide their student ID, the correct mailing address of their institution and the department where their scholarship check is to be received. Award amounts are distributed each semester after a student s final grades are received by Bethlehem Center. 2

3 ADDITIONAL REQUIREMENTS for AWARDEES All recipients must apply for a Pell Grant. If applicant is awarded a scholarship, 24 volunteer hours per academic year must be worked in Bethlehem Center programs. Volunteer hours are counted beginning May 1 st in the spring and ending in May the following year. All scholarship recipients need to coordinate a plan on how they intend to meet their service requirement with the Bethlehem Center. After accepting the scholarship and before beginning their first semester. Scholarship checks are mailed for the next semester only after grades from the previous semester are received. Students must receive a minimum of a 2.5 grade point average based on a 4.0 academic scale. Deadline for the application is Friday, April 24, Applications postmarked after this date are not eligible. Please mail or submit application in person to: Renée Bromfield Director of Community Relations Bethlehem Center of Charlotte 2702 Norfolk Avenue Charlotte, NC

4 Please check one of the following: Application 2015-must be filled out by applicant. New Scholarship applicant Scholarship Renewal Please type on a separate sheet or print your answers below. If application is illegible it is returned. 1 Last Name: First Name: 2 Mailing Address:: Street: City: State: ZIP: 3 Daytime Telephone Number: ( ) - address: 4 Current High School: Number of years attended School: 5 I plan to attend school in the Fall of 2015 YES NO School Name Mailing Address:: Street: City: State: ZIP: 6 What year will you enter college? Freshman Sophomore Junior Senior 7 Will you be a full time student? (This is usually 15 hours or more per semester 8 Do you plan to be a commuting student? YES or NO (circle one). Will you live on campus? If yes, where do you plan to live? If you are not living on campus, where do you plan to live? 9 Grade Point Average (GPA): (On a 4.0 scale) Attach proof of GPA; your most recent official school transcript required. 4

5 10 ACT Score: Or SAT Score: A copy of your ACT or SAT score sheet on official high school transcript is required. 11 Name & address of parent(s) or legal guardian(s): Use reverse side of application if you need more space. Name (s) Street: City: State: ZIP: Daytime phone Phone(s) of parents or legal guardians: 12 List expenses you expect to incur per semester or quarter: (Approximate figures acceptable) additional comments if needed. THIS MUST BE COMPLETED! Make A. Tuition: Amount: $ B. Books: Amount: $ C. Room & Board: Amount: $ D. Other expenses: Amount: $ E. Other expenses: Amount: $ 13 List other financial assistance you will receive per semester or quarter: THIS MUST BE COMPLETED! A. Family Members Amount: $ B. Other Scholarship(s): Amount: $ C. Grants: Amount: $ C. Student Loan(s): Amount: $ D. Other Financial Resources: Amount: $ Please list the following information on a separate sheet if needed. 14 SCHOOL EXTRA-CURRICULAR ACTIVITIES: Please list school extra-curricular activities in which you have participated. Note leadership roles and dates. 15 AREA OF STUDY: What do you want to study and why? 5

6 16 ORGANIZATIONS: Please list community organizations such as service, volunteer and religious organizations where you are currently active or have previously participated in programs the past four years. Note leadership roles and dates. 17 RECOGNITIONS: Please list important awards and recognitions received. Note organizations presenting honor and date. 18 GOALS: What are the short and long term goals for your life? Short: Long: 19 NEED: Please explain your need for the Bethlehem Center Scholarship. 20 CAREER PLANS: What are your career plans and what would you like to be doing in 10 years? 21 A. The following items must be attached to this application in order for the application to qualify to be reviewed by the scholarship committee. B. Your application will be returned to you if these items are not attached to the application. (No exceptions.) C. Circle YES or NO to be sure you have attached each item as required. Two academic reference forms. Have references mail forms to the Bethlehem Center YES NO marked attention Renee Bromfield/ Scholarship Committee. (For high school seniors only.) YES NO One community reference form. Have your reference mail this letter to the Bethlehem Center marked attention Renee Bromfield/ Scholarship Committee (Individual cannot be related to the applicant.) (For high school seniors only.) YES NO Proof of college acceptance or current student enrollment. A letter of college acceptance or program acceptance is required for receipt of funds. YES NO Your most recent official high school or official college transcript (for current scholarship recipients.) Photocopies of your transcript are not acceptable. YES YES NO NO Proof of need for financial assistance: (ex. Parent s tax return.) Answers to questions

7 STATEMENT OF ACCURACY I hereby affirm that all the above stated information provided by me to the Bethlehem Center Scholarship Committee is true, correct and without forgery. I also consent that my picture and information may be taken and used for any purpose deemed necessary to promote the Making a Difference Scholarship Program. I hereby understand that if chosen as a scholarship winner, according to Bethlehem Center s Scholarship Policy, I must provide evidence of enrollment/registration at the institution of my choice before scholarship funds are awarded. Signature of scholarship applicant: Date: Witness Date: 7

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