Watertown High School Scholarship Application 2016 Name (Last, First): Please submit the original and three additional copies by Thursday, February 11, 2016. Additional applications can be found at: http://www.watertown.k12.wi.us/schools/high/whsscholarships.cfm Available Scholarships: 1. Betty J. Joseph Scholarship 19. Watertown Outboarders 2. Rev. & Ruth Lemke Memorial Scholarship 20. Stan Larsen Memorial 3. Joe Davies Scholarship 21. Lions Club 4. Muriel Thauer 22. Hospitality & Culinary Scholarship 5. Edna H. Wiegel 23. Watertown Country Club Women s Assoc. 6. Brandt/Quirk 24. Watertown Kiwanis Noon Club* 7. Earl & Al Maas Family 25. John & Joyce Byrne 8. Joseph & Sharon Darcey Foundation 26. Student Council (4 Year) 9. Henry T. Geib, Sr. Memorial Scholarship 27. Emory L. Grady 10. Larry & Sally Reich 28. Lorna Voigt Grady 11. Ella Reubhausen 29. Student Council (2 Year) 12. Rotary Scholarship 30. Isabelle Jaedecke Business 13. Volunteers of Watertown Regional MC 31. Isabelle Jaedecke Nursing 14. Beatrice Schumann Scholarship 32. Jefferson County Masonic Lodge #9 15. Romilda Rohr Memorial 33. American Legion Family Nursing 16. Edwin F. Hulbert 34. Grace Thompson Memorial Scholarship 17. Josephine N. Hulbert 35. Philip G. Trepte Memorial Scholarship* 18. Matthew R. Zindars Memorial 36. James L. Bloor Scholarship *Please see additional requirements found on last page of application. Only complete applications will be considered for scholarship awards. Application Deadline: Thursday, February 11, 2016 (WHS Guidance Office) NO EXCEPTIONS Scholarship Awards Night: Monday, May 16, 2016 at 7 p.m. in the WHS Auditorium 1
Student Information Name (Last, First Middle): Date of Birth: SS#: Address (Street, City, State, Zip): Selected College(s): Planned Major: Composite ACT Score (highest): *If you list multiple colleges, it is your responsibility to contact Mrs. Fischer (S268) with your final decision by April 1 st. Family Information Guardian Name: Relationship: Address (Street, City, State, Zip): Employer: Position: Guardian Name: Relationship: Address (Street, City, State, Zip): Employer: Position: 2
List all children living at home (applicant first): Name Age Listed as Dependent? Year/Grade School Attending Other dependents receiving financial support from family: Explain any special family circumstances the scholarship committees should know, such as: divorce, separation, unemployment, illness, widowhood, special housing problems, etc. 3
Name (Last, First): School & Community Activities School Activities/Athletics 9 10 11 12 Honors/Awards/Offices Held 9 10 11 12 Community Activities Employer: From: To: Number of Hours Worked Weekly: Employment Dates & Employer Employer: From: To: Number of Hours Worked Weekly: 4
Personal Statement On a separate sheet of paper, type what you have gained from your years in school and what you intend to gain from further education. Please include your name and signature on the essay. 5
Name (Last, First): Financial Information This financial information is required for need-based scholarships and consists of three parts: (A) a copy of the parents latest 1040 Income Tax Form (first page only), (B) a copy of the student s latest Income Tax Form (first page only) and (C) the data to be furnished below. Both (A) & (B) must be attached to this application. If you have not completed your taxes at this time, please submit last year s data. Please submit current year s tax return once filed to the Scholarship Chairperson, Deb Fischer in room S268. Monetary Scholarship/Awards from University: $ (Required to report upon verification of scholarship) Parents Assets Cash, savings, & checking accounts: $ Parents or childrens past inheritance or settlements: $ Parents monthly home mortgage or rental payment: $ If parents own home: Year Purchased: Purchase Price: $ What is it worth today? Home (renters write 0 ) $ $ Business, Rental, or Other Real Estate $ $ Investments (Stocks or Bonds) $ $ Other Investments (Educational Savings) $ $ Roth IRA $ $ Farm $ $ What is owed on it? 6
Name (Last, First): Authorization Student s Authorization: I have completed this form to the best of my ability and all questions are answered accurately and honestly. I understand that upon receipt of a full-tuition or full-ride scholarship, I may be asked to waive my right to the Betty Joseph and/or Rev. & Ruth Lemke Scholarships. For a fair evaluation as a scholarship candidate, I hereby release all academic records, including a transcript, to the Scholarship Committees. Student Signature Date Parent s Authorization: I/We have checked this form for omissions and errors and to the best of our knowledge the information reported is completed and accurate. We authorize its transmittal along with all academic records, including a transcript, to the Scholarship Committees. Parent Signature Date Parent Signature Date 7
Special WHS Scholarships These WHS Scholarships are available to WHS graduating seniors. Each requires a separate application or other paperwork to be submitted with the WHS scholarship application packet. This information can be found in the WHS Guidance Office or on the WHS Scholarship Webpage: http://www.watertown.k12.wi.us/schools/high/whsscholarships.cfm AAUW - $1,500 (2) For a senior who has a 3.2 or better cumulative grade point average, who is active in the school and community, and has a job background. Letters of recommendation are required. American Legion Auxiliary Unit 189 - $500 (1) Must be a graduating student who is a son/daughter, grandchild, or sibling of a veteran. Must attend a technical school or college. A short essay is required. Coach J s JamFest TBA (TBA) Separate application and essay: How will you leave your mark in the world? Glory Global Solutions - $500 (1) Intended for a WHS senior student, whose parents or grandparents work at Glory Global Solutions. Must have a 3.0 or better cumulative grade point average, and high extracurricular/community involvement. Jefferson County Area Retired Educators - $1,000 (1) Intended for a graduating senior in Jefferson County who is majoring in Education, attending a four year school, has a 3.0 or better cumulative grade point average, and involved in two or more activities. Maury Kieffer Memorial Scholarship - $1,000 (1) Intended for a student continuing education in Agriculture. Student must currently have a cumulative grade point average of 3.0 or higher. Must attend 4 year or 2 year college in Wisconsin Farm and Industry Short Course Program and maintain a C average or higher to remain eligible. Three letters of recommendation are needed. Saturday Club - $1,000 (1) Intended for a graduating senior who currently holds an IEP for at least one year during high school. Graduating senior must be enrolled in an accredited post-secondary school. 8
Tri-M Music Honor Society - $500 (1) This scholarship is intended for a student who has a high level of involvement in the Tri-M Music Honor Society and Music Department. Students must have participated in co-curricular music activities. Scholastic success and involvement in the community also necessary. Watertown Regional Medical Center Health Careers Scholarship - $1,000 (2) This scholarship is intended for a senior student who has been accepted into the healthcare program at a 2 or 4 year college. Students must be in the top third of their class and have strong participation in school and community activities. Watertown Regional Medical Center Medical Staff Scholarship $6,000 (1) Student must have a cumulative grade point average of 3.5 or higher and intending to obtain a 4 year degree or higher in the health care field. Watertown Agri-Business Club Scholarship - $500 (1) This scholarship is intended for a graduating senior who is continuing their studies in the field of Agri-Business at a college, vocational school or the University of Wisconsin short-course. Student must have maintained a C average or higher in high school. Three letters of recommendation are required. Watertown Booster Club - $1,000 (TBA) This scholarship is for a graduating senior who has attended WHS for at least their junior and senior year. The recipient must have lettered in 2 varsity WIAA sports and have a cumulative grade point average of 2.5 or higher. Parental involvement in Booster Club is considered. Watertown Conservation Club - $1,000 (1) This Scholarship is intended for a graduating senior who is entering the field of conservation/environmental studies. Watertown FFA Alumni Scholarship - $TBA (1) Intended for a student pursuing a career in agriculture at a 4 year, 2 year or specialized college. Students must be active in the FFA and an experimental learning project or SAE. 9
*Kiwanis Club Student must have completed the additional guidelines which can be found on the WHS Scholarship Webpage and attached to the WHS Scholarship Application. *Philip G. Trepte Memorial Scholarship Student must complete the additional guidelines which can be found on the WHS Scholarship Webpage and attached to the WHS Scholarship Application. 10