Burlington High School Common Application Directions Open the BHS web page at: http://www.basd.k12.wi.us/bhs Click on: Scholarship Information. From the left menu, select Counseling Office, then Scholarships. Please read all attachments and instructions. There is a link to the Common Application. Remember you will need to make copies of your complete application and recommendation letters to use for each scholarship for which you apply. BURLINGTON HIGH SCHOOL SCHOLARSHIPS COMMON APPLICATION (Applications are due in the Counseling Office by April 14, 2016) The scholarships listed on this page will all accept a common application form. Each scholarship requires a separate application form. Please indicate on the front of each application form for which scholarship it is intended. Just a reminder: The Counseling Department will NOT make copies of your forms. Each application requires a copy of your two recommendation letters and a copy of your high school transcript. Upon your request, the Counseling Office will provide you with one copy of your transcript. You will be responsible to make any additional copies of your transcript. BURLINGTON HIGH SCHOOL GENE EDMUNDSON (played a varsity sport) GILBERT J. & ROSE NELSON HOWARD (Attend college in WISCONSIN; priority given to nursing, teaching, or business major) (4-year only) OUR HOPE OF BURLINGTON (health related degree, resident of Racine County, B average or better) PARTNERS2 (Must have participated in Partners2 for two years) BURLINGTON CHAMBER OF COMMERCE RON KAHL (played a varsity sport) ROBERT HEFTY/LIONS CLUB (2-year only) *BHS SCHOLARSHIP, INC. *Your application will be routed through appropriate scholarship vendors that you qualify for. (See next page for list)
*BHS SCHOLARSHIPS, INC. AVAILABILITY OF SCHOLARSHIPS ARE SUBJECT TO FUNDING (Applicants need only 1 application to apply for all of the scholarships listed below) GENE SPITZER MEMORIAL SCHOLARSHIP EDWARDS GROUP, INC. MASONIC TEMPLE SCHOLARSHIP PHARMACY STATION SCHOLARSHIP FLORENCE HEFTY/LIONESS CLUB B.H.S. SCHOLARSHIP, INC. KIWANIS SCHOLARSHIP WILLIAM WILSON MEMORIAL SCHOLARSHIP JOHN ROWNTREE MEMORIAL LLOYD GEIKEN MEMORIAL SCHOLARSHIP RUNZHEIMER INTERNATIONAL RUNZHEIMER INTERNATIONAL TERRY HAVEL SCHOLARSHIP JAMES HANSON SCHOLARSHIP HOWARD AND RUTH PETERSON SCHOLARSHIP MARY KAY ROSSMEIER GLORIA DICK MEMORIAL SCHOLARSHIP WINGS OVER WISCONSIN PLYMOUTH CONGREGATIONAL CHURCH SCHOLARSHIP FUNDS BURLINGTON ROTARY CLUB KENNETH C. MCMILLAN SCHOLARSHIP MARION CLIFTON ARAMARK FOOD SERVICE BOB ROOSA FIRE SCIENCE GARY KIELHOFNER MEMORIAL SCHOLARSHIP ETHEL ROBERTS NETTIE E. KARCHER MEMORIAL SCHOLARSHIP LES HOGANSON (4-year science major in Wisconsin) (Business major) (4-year college) (2-year or 4-year college) (Art major or related field) (2-year or 4-year college) (Based on student improvement) (2-year or 4-year college) (2-year or 4- year college) (Business major) (4-year college in U.W. system) (Communication major) (Agriculture/Life Science major) (4-year college, U.W. system, BHS athletics or instrumental music) (Awarded after 1 st year of college) (Elementary education major) (Environmental studies) (2-year or 4-year; some awarded after first year of college) (2-year or 4-year student has studied modern language in high school) (Continuing education) (Hospitality or dietetics) (Fire Science or EMT; 2 or 4-year degree) (2-year or 4-year with focus on health sciences) (4-year) (4-year) 77 CLUB BHS KEY CLUB (Engineering field, awarded after first year of college) SCHOLARSHIP TIPS Always complete all sections on the applications. Typed applications stand out as being well done. Make copies of applications so you may refer to them again. Don t wait until the due date to hand in your scholarship application. Ask people to write recommendations well in advance. Make sure you have the right number of recommendations that the scholarship requires. All applications should be turned into the Counseling Office. If you receive a scholarship, a follow-up thank you note is most appropriate.
Name of scholarship (Please print the name of the scholarship you are applying for on each copy of your scholarship application.) BURLINGTON HIGH SCHOOL SCHOLARSHIPS COMMON APPLICATION The information and data provided in this application will be held in strict confidence. Only those needing to have the information to determine the award winners (scholarship committee members, other officers, Committee members or Board members) will have access to the information. STUDENT IDENTIFICATION All Items Must Be Completed FULL NAME: STREET ADDRESS: CITY: STATE: ZIP: DATE OF BIRTH: FAMILY INFORMATION FATHER OF APPLICANT FULL NAME: STREET ADDRESS: CITY: STATE: ZIP: TELEPHONE# ( ) - PLACE OF EMPLOYMENT: MOTHER OF APPLICANT FULL NAME: STREET ADDRESS: CITY: STATE: ZIP: TELEPHONE# ( ) - PLACE OF EMPLOYMENT: Number of brothers or sisters claimed as dependents by parents:
PRIOR YEAR'S FAMILY ADJUSTED GROSS INCOME RANGE* $15,000 and under $60,000 to $80,000 $15,000 to $25,000 $80,000 to $100,000 $25,000 to $40,000 $100,000 to $125,000 $40,000 to $60,000 Over $125,000 *You may attach a copy of your last year's tax return or your computation of your estimate of this year's tax return amount and any explanation related to the amounts if you believe it would be helpful to the Scholarship Recommendation Committees in determining the NEED portion of the ratings if NEED is a factor in their determination. List other family members presently in college. Name College Year Estimated Cost to Family CAREER PLANS What college or technical school do you expect to attend? Have you been accepted? What do you plan to study? (Major) What do you see yourself doing 5 years from now?
SCHOOL AND OTHER ACTIVITY RECORDS (Include a copy of your transcript as an added page(s) to this application) CLASS RANK OUT OF GRADE POINT AVERAGE List all school sports activities that you participated in: (Include cheerleading and marching band) Activity Years Involved Position (leadership or other) Example: Volleyball 9, 10 Player, Captain List all other school activities that you participate in: Activity Years Involved Position (leadership or other) Example: Student Council 9, 10, 11, 12 Class President
List all outside of school activities that you participate in: Activity Years Involved Position (leadership or other) List all part time and summer work experience: Dates employed Name of Employer Position or type of work
What have you done for your service learning projects? How has your high school experience prepared you for the future? (250 words or less) (If you need more room to report any information needed above fill in another sheet or fill in on the back of this form and reference from the space that isn't adequate.) If you are applying for the Partners2 scholarship, please write an additional essay about how your experiences in Partners2 changed your high school career. What will you carry with you into your future that you experienced within Partners2?