WATERFORD YOUTH ASSISTANCE 5640 Williams Lake Road, Suite 201 Waterford, MI tel fax

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1 PROGRAM Send completed applications to: Waterford Youth Assistance C/O Christie Kay 5640 Williams Lake Road, Suite 201 Waterford, MI Action of Betty Fortino Phoenix Scholarship Committee: Application: Approved Denied Total points awarded by Review Committee: This grant is awarded for School Year beginning Fall: Notice to Applicant: Please read thoroughly the Criteria of Qualifications and the Instructions to Applicants section of this application. The Betty Fortino Phoenix Scholarship is granted to one Waterford student who rose to overcome a life challenge while attending school and volunteering in the community. The student applicant agrees that the use of grant funds shall be predicated on his or her enrollment or continuance of education in a recognized and/or accredited school such as college, university, trade school or business college. The approved funds should be used for such purposes as tuition fees, books and student supplies, rather than for room, board, clothes or living expenses.

2 APPLICATION Name: Address: City: State: Zip: Home phone Cell phone address: Current school: Graduation date: GPA for last school year attending: Application Requirements Applicants are required to submit all paperwork with application. Applicant must be a high school junior who will be entering their senior year for the 2018/2019 school year and is currently attending a Waterford High School, alternative or private institution in Waterford. Applicants must be a resident of the Waterford School District. A copy of school transcript for the last year attended must be included with this application. The last available transcript must be submitted by the September 30, 2018 deadline. No exceptions. All applicants must submit two letters of recommendation. The enclosed form must used and mailed by references. Teacher/School Official/Faculty Member Non Family Member Essay Requirements Each applicant is required to write two essays. Each essay must be typed or written and must be a minimum of one page and a maximum of two pages for each essay topic. 1. A brief autobiography describing: Academic strengths and challenges Work experience and/or volunteer programs Career objectives Rising above a challenge 2. How do you feel volunteerism and community have played a role in your life? Include the importance of volunteerism in the community. Applicant s Signature Date

3 CRITERIA OF QUALIFICATIONS AND INSTRUCTIONS TO APPLICANT 1. This application has been prepared as a frank and friendly means of obtaining necessary information regarding the applicant and the applicant is required to give all information requested. Read the contents carefully and understand each question and all information requested. 2. Every question and statement must be answered and submitted. 3. Answers and essays must be legible. 4. GPA must be at least a 2.0 on a 4.0 scale for high school seniors. 5. Applicant must be a Waterford School District resident at the time of application. 6. Applications will be judged on the essay, the autobiography, references and GPA. 7. One scholarship will be awarded in the amount of $1, Scholarship will be sent directly to recipient s school of choice. 8. Application must be mailed directly to Waterford Youth Assistance, C/O Christie Kay, to be received no later than September 30, 2018 deadline with the following: The two (2) enclosed forms for recommendation (mailed by references) Last available transcript must be submitted by deadline, no exceptions Autobiography Essay *The applicant is responsible to do follow-up with references to ensure they have been received by the deadline. 9. Scholarship recipient will be required to attend the WYA Fall 2018 Annual Meeting on October 24, 2018 to accept the award and read essays.

4 LETTER OF RECOMMENDATION The above mentioned applicant seeks a letter of recommendation for the Waterford Youth Assistance Betty Fortino Phoenix Scholarship. Individuals providing references should complete this form fully and return it to the WYA office. The Betty Fortino Phoenix Scholarship Committee will hold comments in strict confidence. I have known the applicant for years. The applicant s general reputation and character are: I believe the applicant s scholastic ability to be: fair average good excellent superior I believe the applicant s dedication to study to be: fair average good excellent superior I would like to recommend the applicant for scholarship because: Reference Information My profession is I am associated with Address: Telephone: Signature Date Send completed letter of recommendation to: Waterford Youth AssistanceC/O Christie Kay5640 Williams Lake Road, Suite 201Waterford, MI 48329

5 LETTER OF RECOMMENDATION The above mentioned applicant seeks a letter of recommendation for the Waterford Youth Assistance Betty Fortino Phoenix Scholarship. Individuals providing references should complete this form fully and return it to the WYA office. The Betty Fortino Phoenix Scholarship Committee will hold comments in strict confidence. I have known the applicant for years. The applicant s general reputation and character are: I believe the applicant s scholastic ability to be: fair average good excellent superior I believe the applicant s dedication to study to be: fair average good excellent superior I would like to recommend the applicant for scholarship because: Reference Information My profession is I am associated with Address: Telephone: Signature Date Send completed letter of recommendation to: Waterford Youth AssistanceC/O Christie Kay5640 Williams Lake Road, Suite 201Waterford, MI 48329