Laverne F. Fuller Scholarship Application Information



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Application Information Description: The was established in July, 2011, in memory of Mrs. Laverne F. Fuller. The scholarship supports female students who intend to enroll in a vocational or trade school, community college or university upon graduating from high school. This one-time, non-renewable scholarship will award $1,000 to two (2) graduating seniors. Applicants must be enrolled in their last year of high school in the Beaverton School District and must meet the following selection criteria: Graduating senior Female student Intend to enroll in vocational/trade school, community college or university upon graduation Commitment to volunteerism and community service Self-initiator Application Directions: The application consists of three (3) written parts, three (3) reference forms, and an interview process for the finalists. ALL PARTS OF THIS APPLICATION MUST BE COMPLETED IN INK OR TYPED. PART I is general information. This page will be separated from the rest of the application and is the only page on which the applicant's name will appear. The scholarship committee will accomplish the initial screening of applicants using only Part II and III on which the applicant will be identified by an assigned number. PART II asks the applicant to answer briefly ten (10) questions about themself. Complete sentences are not necessary in this section. PART III asks the applicant to expand the answers to three (3) of the questions in Part II, limiting the answers to no more than fifty (50) words each. Obtain three (3) references from school- or community-based adults (NOT a family member or a friend) whom the scholarship selection committee could request more information about you. Make sure to fill out the parts of the recommendation form that are required by you. Participate in an interview if selected based on the written applications. This will an opportunity for the applicant to expand on their written portion of the application. Please mail, fax, hand deliver, or e-mail directly to: Mike Chamberlain, Administrator for High School and Option Programs, Attn: Colleen Conceicao Teaching & Learning Department, 16550 SW Merlo Rd., Beaverton, OR 97006 503-591-4429 (phone) 503-591-4415 (fax), colleen_conceicao@beaverton.k12.or.us Deadline: Wednesday, April 10, 2014 at 4 p.m.

Application PART I Name: Student ID #: Mailing Address: Phone Number: Home: Cell: Current School Attending: Signature: Today s Date: DIRECTIONS: Please list three (3) school- or community-based adults (NOT a family member or friend) whom the scholarship selection committee could request more information about you. Name Relationship to Applicant Phone Number HIGH SCHOOL GRADES: Do you feel that your high school grades need additional explanation? ATTENDANCE: Do you feel that your attendance record in high school needs further explanation? FOR OFFICE USE ONLY DATE RECEIVED ATTENDANCE RECORD ATTACHED TRANSCRIPT ATTACHED GRADE 12 REPORT CARD(S) ASSIGNED NUMBER

Application FOR OFFICE USE ONLY: Assigned Number PART II Please answer all of the following questions as concisely as possible in the space provided. 1. Vocational/Trade Interests: List the vocational/trade programs, community college or university you intend to enroll upon graduating from high school. 2. Motivational Factors: What motivated you to explore the above vocational/trade interest areas? 3. Success Potential: Why do you feel you will be successful in the vocation/trade you have chosen? 4. Anticipated Challenges: What might be the potential challenges in becoming successful in the vocation/trade of your choice? How do you plan to overcome those challenges? 5. Future Potential: In what ways will your plans for the future contribute to society?

(Part II Continued) 6. Community Contributions: List the service groups and volunteer activities in which you have participated during high school. 7. Self-Initiative: Give a specific example of a situation where you demonstrated self-initiative. 8. Financial Need: How do you plan to finance your post high school vocational/trade program? 9. Personal Influences: What person(s) or incident(s) have most influenced you to be who you are today? 10. Other Information: What other information do you want the committee to know about you when it is considering your application for this scholarship?

Application FOR OFFICE USE ONLY: Assigned Number PART III You have answered 10 numbered and titled questions in PART II. In this section, please select three (3) of those questions that you would most like to explain further. Please answer them in order of importance, most important first. Limit your answer to 50 words. You may use an additional paper. Question #: Title: Question #: Title: Question #: Title:

(To be completed by the student) Name of student: Student s Post-High School Areas of Interest: (To be completed by the recommender) Name of person completing this form: Reference Form Title/Position: Phone Number: Organization: E-mail: The student named above is applying for the in the Beaverton School District. The scholarship supports graduating female students who intend to enroll in a vocational/trade program, community college or university upon graduating from high school. Students are selected based on their interest in vocational/trade interest, volunteerism and/or involvement in service groups, and demonstrated self-initiatives. 1. In what capacity have you known this student and for how long? 2. Has this student? A. Always worked to capacity B. Usually worked to capacity C. Seldom worked to capacity D. No basis for judgment 3. How would you rate this student's accomplishment, in particular in the area of volunteerism and community service? A. Excellent B. Good C. Average D. Below average

4. How would you rate this student s ability to self-initiate? A. Excellent B. Good C. Average D. Below average 5. Based on what you know, how do you think this student will be successful in the vocational/trade area of his/her choice? 6. How would you assess this student s financial need? A. Very needy B. Needy C. Little need D. No need E. No basis for judgment 7. Is there any other information the committee should have in considering this student s application? Signature: Date: Please mail, fax, or e-mail directly to: Mike Chamberlain, Administrator for High School and Option Programs, Attn: Colleen Conceicao Teaching & Learning Department, 16550 SW Merlo Rd., Beaverton, OR 97006 503-591-4429 (phone) 503-591-4415 (fax), colleen_conceicao@beaverton.k12.or.us Deadline: Friday, April 10, 2012 at 4:00 p.m.