Due Date April 4, Return to: Tucker Community Foundation P.O. Box 491 Parsons, WV 26287 PERSONAL INFORMATION Name of Applicant: SS#: First M.I. Last Current Address: PO Box or Street City State Zip Code Phone Number: E-mail Address: Father/Guardian: Name Address if different from applicant Mother/Guardian: Name Address if different from applicant List household residents and their ages (including all adults and children): How many household residents will be enrolled in college next year? ACADEMIC INFORMATION Name of School Attending (including the City & State) Major(s) If the applicant is currently a college student, the student needs to provide TCF with an official transcript from the college.
PERSONAL STATEMENT Please use this sheet to write a personal statement (not to exceed 500 words and one page total). This application has also been created in a PDF format to allow you to type the information directly into the application. If you are using the PDF application you may wish to type and edit the Statement in another computer program and then copy and paste below. The statement should include your educational and career goals. Also explain what you have done or plan to do to help yourself achieve these goals. Please do not repeat information from elsewhere in this application.
ACTIVITIES Please list below all school, church and community activities during your college years or post high school activities if you are a Non-Traditional Student. Include any special projects or awards and when you were involved in each activity. Examples for College students: Marching Band 13(or First year) Alpha Beta Gamma Fraternity 15 (or Third Year). Examples for Non- Traditional Students: Middle School Soccer Coach 2012-2013, Run For It Library Team 2011. You may need to use more than one page. Please note that you are required to use this form sheet. Please make multiply copies for additional pages. Other types of submission will not be accepted.
OTHER SCHOLARSHIP INFORMATION List other scholarships you have applied for (indicate if you have received an award notification): You are required to notify the TCF office of any grants or scholarships you receive after you submit this application. Failure to do so may negatively affect your application or result in the rescinding of any awards. Do you have a financial need in order to continue your education? yes no If yes, please provided details: Do you plan to work while attending college? If yes, how many hours/week: After graduating from college or other post high school educational facility, do you plan to return to work in the county you graduated from? If not, Why? If so, what are your work plans?
SPECIAL AWARD CRITERIA: Please respond if applicable: 1. Name of parent or grandparent who is a member of the Davis Fraternal Order of Eagles: 2. Name of relative(s) who currently work for PCM, Inc. or any of its subsidiaries: 3. I am a descendant of a Parsons High School Graduate: a. Name of relative(s) who graduated from Parsons High School: 4. I reside in the Hambleton/Hendricks area: 5. I am from the former St. George, Clover, or Licking districts in Tucker County: 6. I am a descendant of the Walter and Mary Shaffer Helmick family: 7. I am from the Union district in Grant County or the Elk District in Mineral County: 8. I have completed two or more courses in JROTC: 9. I have a parent (mother or father) who is Veteran or an active duty member of the U.S. Army, U.S. Navy, U.S. Marine Corps, U.S. Coast Guard, or U.S. Air Force: Name: PHOTOGRAPH Student must submit a wallet-sized picture (headshot only no artistic or unusual pictures) with the application. Include student s name and social security number on the back of pictures submitted by mail (do not tape or adhere the photo to the application). Electronic pictures preferred; e-mail to tcf1@frontiernet.net. In submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge. I also certify that I have read the instructions and will comply with all requests for grade reports, transcripts, notification of other scholarship awards and change in plans, should I receive a scholarship. I understand that falsification of information will result in rescinding of any scholarship granted. Applicant s Signature Date
SCHOLARSHIP APPLICATION CHECKLIST The application becomes complete and valid only when you have returned the following materials by the application due date of April 4, (Postmark deadline). Incomplete applications will not be forwarded to the Scholarship Review Committee. Completed Application Form Official College Transcript (if applicable) Special Award Criteria Questions Answered Personal Statement Activity Sheet Photograph Please note: All attachments should be made on 8 ½ x 11 paper All applications and attachments must be mailed; transmissions by facsimile will not be accepted. For further information contact the TCF: Tucker Community Foundation P.O. Box 491 Parsons, WV 26287 Telephone: (304) 478-2930 Email: tcf1@frontiernet.net
Tip Sheet Tips for College Student/Non-Traditional Applicants: Please complete your activity sheet for any activities you participated in from High School graduation and beyond. Make sure the activity sheet is complete. You must submit an official college transcript. Most colleges and universities prefer to submit transcripts directly to the Foundation so make sure they have the correct mailing address for TCF. Applications by college students without an official transcript are typically not competitive. Early application is encouraged.