The OPHELIA Foundation Class of 2017 Scholarship Guidelines Scholarship Application Deadline: 11:59 p.m. EST, Friday, March 31, 2017

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1 The OPHELIA Foundation Class of 2017 Scholarship Guidelines Scholarship Application Deadline: 11:59 p.m. EST, Friday, March 31, 2017 The OPHELIA Foundation Class of 2017 Scholarships The OPHELIA Foundation is pleased to announce its Class of 2017 Scholarships. The OPHELIA Foundation Class of 2017 Scholarships support graduating seniors from a northern Virginia high school in the City of Alexandria, Arlington County, Clarke County, Culpeper County, Fairfax County and Fairfax City, Falls Church City, Fauquier County, Frederick County, Loudoun County, Manassas and Manassas Park, Prince William County, or City of Winchester. Eligibility requirements and instructions for applying for the 2017 scholarships are outlined below. Only applications received by 11:59 p.m. EST, Friday, March 31, 2017, will be considered. Eligibility Requirements A Class of 2017 Scholarship applicant must be: 1. A graduating senior from a Northern Virginia high school in the City of Alexandria, Arlington County, Clarke County, Culpeper County, Fairfax County and Fairfax City, Falls Church City, Fauquier County, Frederick County, Loudoun County, Manassas and Manassas Park, Prince William County, or City of Winchester; 2. A U.S. citizen; 3. Accepted as a full-time, frst-term matriculating freshman at an accredited college or university (excluding the Army, Navy, or Air Force Academy) or an accredited two-year community college at the time the award is presented; 4. Planning to pursue a baccalaureate degree; 5. Eligible for the scholarship award as determined by the donor s criteria (refer to the scholarship description for specifc criteria). Scholarship Awards Eligibility requirements for The OPHELIA Foundation Class of 2017 Scholarships are based on criteria set by the donor. Applicants are encouraged to apply for all scholarships for which they are eligible. However, only one scholarship will be awarded to an applicant. The one-year Class of 2017 Scholarships will be paid to the recipient in two disbursements (contingent on the terms of the scholarship Memorandum of Understanding): one for the fall semester and one for the spring semester of the recipient s freshman year. 1

2 Scholarships for the Class Of 2017 Please indicate the scholarship(s) for which you are applying: The Ophelia Scholarship ($1,000). See application requirements on Page 3. The Gil and Jameece Pinckney Scholarship ($1,000). See application requirements on Page 4. Application Requirements for The Ophelia Scholarship ($1,000) Applicants for The Ophelia Scholarship must provide: 1. A completed application, neatly typed or printed, all questions answered, and signed by the parent/guardian and the applicant. 2. Offcial high school transcript (with school s seal and in a sealed envelope). 3. Information stating or showing your status as a U.S. citizen (ex. certifed birth certifcate, U.S. Passport). 4. Two letters of recommendation from: Teacher or Counselor and/or Community Leader 5. Documentation confrming you are a graduating senior from a northern Virginia high school in the City of Alexandria, Arlington County, Clarke County, Culpeper County, Fairfax County and Fairfax City, Falls Church City, Fauquier County, Frederick County, Loudoun County, Manassas and Manassas Park, Prince William County, or City of Winchester. 6. Evidence that you have a minimum grade point average of 2.75 on a 4.0 scale. 7. Verifcation that you meet all scholarship eligibility requirements. 2

3 8. A copy of your most recent Free Application for Federal Student Aid (FAFSA) Report. 9. A typewritten resume listing extracurricular activities (schools, community, church, etc.), jobs, and honors and awards received. 10. A typed, 500-word essay that addresses the following topic: Essay Topic San Francisco 49ers quarterback Colin Kaepernick refused to stand for the playing of the national anthem in protest of what he deemed were wrongdoings against African-Americans and minorities in the United States. Do you think Colin Kaepernick went too far? Would you be willing to take a controversial stand for something you believe in? If so, how would you communicate your beliefs? Application Requirements for The Gil and Jameece Pinckney Scholarship ($1,000) Applicants for The Gil and Jameece Pinckney Scholarship must provide: 1. A completed application, neatly typed or printed, all questions answered, and signed by the parent/guardian and the applicant. 2. Offcial high school transcript (with school s seal and in a sealed envelope). 3. Information stating or showing your status as a U.S. citizen (ex. certifed birth certifcate, U.S. Passport). 4. You must have been actively involved in band, choir, or sports for two years. 5. Two letters of recommendation from: Teacher or Counselor and/or Community Leader and Band/choir leader/sports coach, as applicable, certifying your involvement in the activity for two years 6. Documentation confrming you are a graduating senior from a northern Virginia high school in the City of Alexandria, Arlington County, Clarke County, Culpeper County, Fairfax County and Fairfax City, Falls Church City, Fauquier County, Frederick County, Loudoun County, Manassas and Manassas Park, Prince William County, or City of Winchester. 7. Evidence that you have a minimum grade point average of 3.0 on a 4.0 scale. 8. Verifcation that you meet all scholarship eligibility requirements. 9. A copy of your most recent Free Application for Federal Student Aid (FAFSA) Report. 10. A typewritten resume listing extracurricular activities (schools, community, church, etc.), jobs, and honors and awards received. 11. A typed, 500-word essay that addresses the following topic: 3

4 Essay Topic San Francisco 49ers quarterback Colin Kaepernick refused to stand for the playing of the national anthem in protest of what he deemed were wrongdoings against African-Americans and minorities in the United States. Do you think Colin Kaepernick went too far? Would you be willing to take a controversial stand for something you believe in? If so, how would you communicate your beliefs? 4

5 The OPHELIA Foundation Class of 2017 Scholarship Application Please indicate the scholarships for which you are applying: The Ophelia Scholarship The Jameece and Gil Pinckney Scholarship Name: Click here to enter text. Click here to enter text. Address: Click here to enter text. Telephone: (Home): Click here to enter text. Cell: Click here to enter text. Gender: Click here to enter text. Date of Birth: Click here to enter text. U.S. Citizen U.S. National U.S. Permanent Resident (If you are a U.S. permanent resident, you must include a letter stating your intent to become a U.S. citizen and a copy of your permanent registration card.) GPA: Click here to enter text. High School Name and Address: Click here to enter text. Click here to enter text. Please include a typewritten resume listing all extracurricular school and community service activities you have participated in during high school, and give the dates. Include all honors and awards received and jobs. What college/university do you plan to attend? Click here to enter text. Please enclose a copy of your acceptance letter (if available). Proposed Field of Study: Click here to enter text. Name of Parent/Guardian: Click here to enter text. Address: Click here to enter text. Occupation of Parent: Click here to enter text. 5

6 # of siblings under 21: Click here to enter text. # of siblings in college: Click here to enter text. NOTE If you are selected as a scholarship recipient, you must sign a Memorandum of Understanding with The OPHELIA Foundation prior to the disbursement of the scholarship funds to the educational institution. Scholarships paid to individuals are generally taxable income to that person. However, a candidate for a degree can exclude the amount received as a qualifed scholarship from taxable income. Specifc questions regarding the tax treatment of this scholarship should be directed to a tax advisor or the Internal Revenue Service. Media Disclaimer As a recipient of a 2017 OPHELIA FOUNDATION Scholarship, you consent to allow The OPHELIA Foundation to use your name, image, and quotes in still photography for the purposes of advertising, publicity, and promotional materials. This includes print and electronic communications, but it is not limited to The OPHELIA Foundation , website, and social media page. I agree that The OPHELIA Foundation shall own the copyright to the photography. I hereby release to hold harmless The OPHELIA Foundation for any liability for any violations of any personal rights or any other rights I may have arising from or in connection with The OPHELIA Foundation s use of photography. This is not limited to errors, blurring, distortion, or alteration of the photography. I/we certify the information in this application is true to the best of my/our knowledge. Signatures: Applicant Date / / Parent/Guardian Date / / 6

7 The OPHELIA Foundation Class of 2017 Scholarships Application Checklist Please check each item included in your packet. Review the application and all attachments for accuracy and completeness before submitting. Incomplete applications will not be considered. Be certain that you address or include each of the following items in your application packet: A completed application, neatly typed or printed, all questions answered, and signed by the parent/guardian (if required) and the applicant Verifcation that you meet all scholarship eligibility requirements Most recent transcript (with school s seal and in a sealed envelope) Information stating or showing your status as a U.S. citizen Offcial information confrming you are a graduating senior from a northern Virginia high school in the City of Alexandria, Arlington County, Clarke County, Culpeper County, Fairfax County and Fairfax City, Falls Church City, Fauquier County, Frederick County, Loudoun County, Manassas and Manassas Park, Prince William County, or City of Winchester Two letters of recommendation A 500-word typewritten or printed essay Proof of acceptance into an accredited two-year community college or fouryear accredited college or university Copy of your most recent Free Application for Federal Student Aid (FAFSA) Report All applications and supporting materials must be received by Friday, March 31, 2017, no later than 11:59 p.m. EST. Mail offcial transcripts to: The OPHELIA Foundation Attention: Scholarship Committee 5041 Grand Beech Court Haymarket, VA Send all other paperwork to the above address, or it to: info@opheliafoundation.org All s must be received by Friday, March 31, 2017, no later than 11:59 p.m. EST. 7