Families for Russian and Ukrainian Adoption (FRUA) Scholarship Program Application for Dina Brown High School Senior Scholarship

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1 Families for Russian and Ukrainian Adoption (FRUA) Scholarship Program Application for Dina Brown High School Senior Scholarship Application Deadline: Submitted by March 17, 2017 Application must be filled out by applicant. Please read all instructions carefully before completing. Please type or print neatly. Personal Information Student Name: Home Address: City, State: Zip Code: Phone (incl. area code): Date of Birth: Family Information Parent Name: Home Address: City, State: Zip Code: Phone (incl. area code): Parent Name: Home Address: Citv, State: Zip Code: Phone (incl. area code):

2 Adoption Information Birth Country: Adoption Date: Adoption Agency: FRUA Affiliation Current FRUA Chapter (or unaffiliated): Parent address: In the fall of 2017, I plan to attend: D 4-year college or university D Community college or junior college D Trade or technical school Intended major/course of study: Eligibility 1. Applicant must be a FRUA member's dependent child adopted from Eastern Europe/Eurasia/Caucasus. 2. Applicant must be a current high school student. 3. Applicant must be a student enrolled in an accredited college, university, community college, or technical or trade school by the time of the award. 4. Awards must be used for the school year. 5. Awards will be paid directly to the school attended by the recipient. 6. Applications must be submitted via by March 17, 2017, in order to be considered.

3 Award Amount FRUA will award $1,250 to the top-rated applicant. Payment will be made directly to the school the recipient attends in fall Award Criteria A wards will be based on academic achievement/potential, character, leadership, social and/or community participation, and career goals. A grade point average (GPA) of3.0 or higher is recommended but not required. Financial need is NOT a consideration. Applications will be judged by a committee of impartial members of the FRUA National and/or Advisory Board, or others duly appointed by the National Board. The committee chair will be a member of the National Board. Only one scholarship will be offered per student. A student can only receive one FRUA scholarship in his/her academic career. Children of current FRUA National Board members are ineligible. Application Instructions 1. The applicant must complete the application. Parents may assist but cannot complete the application for the child. Please type or print neatly. 2. All requirements must be met and all information must be completed in order for the application to be considered. 3. Enclose with your application one letter of reference on letterhead from a teacher or other adult who is familiar with your achievements and abilities. Applications without letters of reference will not be considered. 4. Attach an essay ofno more than 500 words (on a separate sheet of paper) describing your career goals, aspirations, and community service. Highlight your relationship with FRUA and/or the adoption community, how adoption has affected your life, and explain why you are a good choice for a FRUA scholarship. Applications without an essay will not be considered. 5. Ensure applicant name appears at the top of any additional sheets submitted. 6. Review and complete the application checklist and sign the certification statement. 7. Submit application as a single pdf in an to secretary@frua.org. 8. Retain a copy oft he completed application for your files. Disclaimer: FRUA reserves the right to determine whether all scholarship award5 will be made in a given year. If the scholarship committee deems that a sufficient number of qualified candidates has not applied, one or more of the scholarships/amounts may not be awarded that calendar year.

4 Educational Background (for high school only) School Name School location Attendance (city/state) dates Grade Point Class Average* (Ex. 3.5/4.0, rank/class 4.1/5.0) size If you are selected as a scholarship recipient, you may be required to verify your grade point average by supplying a copy of your high school transcript before receiving the award. Class rank may also be verified at the discretion of the scholarship committee. SAT or ACT Scores Check the box next to the test taken and enter your total score. D SAT, total score: D ACT, total score: D Tests not required for my school. Scholarship recipients may be required to verify test scores before receiving the award. Schools to which you have applied: Accepted(Y IN) 1 st Choice: Location: nd Choice: Location: 3rd Choice: Location: Anticipated post-secondary school graduation date: Letter of Reference: Please include one recommendation letter on letterhead from a teacher or other adult who is familiar with your achievements and abilities. Applications without a letter of reference will not be considered.

5 Essay: The essay is an essential element of your application package. The quality and relevance of your essay are significant determining factors for earning this scholarship. Please submit a typewritten essay of 500 words or less on a separate sheet of paper. Your essay should outline your career goals, aspirations, and community service. It should also describe your relationship with FRUA and/or the adoption community, how adoption has affected your life, and why you are a good choice for a FRUA scholarship. Please ensure your name appears at the top of your essay. Awards/Activities: Please provide information on any employment you have held. Attach additional sheets if needed. A resume may be provided. Please provide information on any special honors or awards you have received. Attach additional sheets if needed. A resume may be provided. Please provide information on extracurricular or outside activities (e.g., clubs, sports, volunteer work) in which you have participated. Attach additional sheets if needed. A resume may be provided.

6 Certification Statement I,, certify that I completed this FRUA scholarship application myself. 1 further certify that the application's contents are accurate and truthful to the best of my knowledge. Signed,

7 Important Information > To submit your application, compile a single pdf of your application forms, your letter of reference on letterhead. your essay. and your signed certification form. Applications without this information will not be considered. }- this pdf to secretary@frua.org. DO NOT send your application via regular mail-hard copy packages will not be accepted. )i> The scholarship committee will send you confirmation of its receipt of your application within a few days of submittal. )- FRUA will not provide information on the status of submitted applications during the review process. Please do not contact the FRUA info line for status updates. > FRUA will notify the scholarship recipients by May 31, FRUA will subsequently notify those applicants who were not selected for the scholarship. > The name, picture, and essay of the scholarship recipient may be published in FRUA's membership journal, The Family Focus, on FRUA's web site, or in other FRUA publications/media. > Do not enclose a copy of your school transcript or standardized test scores. > Applications must be signed in order to be considered. Checklist Use this checklist to complete your application. All materials must be submitted with this application. Materials sent separately will not be considered. Your application will not be considered if materials are missing. > Application. Complete all sections of this application. > Letter of reference. Provide one recommendation letter on letterhead. r Essay. Type a 500-word essay and enclose with application. }- Signature. Review application and sign on the certification page. }- Copy. Retain a copy of the completed application for your files. r submission to secretary@frua.org by March 17, FRUA will confirm receipt of your application.

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