2017 SCHOLARSHIP AWARD APPLICATION

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1 2017 SCHOLARSHIP AWARD APPLICATION Must be submitted and received by February 1, 2017 Our Mission The Elliott-Chandler Foundation supports the development of leaders of tomorrow by providing financial support and critical assistance to deserving young men with a demonstrated record of academic performance and an interest in pursuing a degree from a higher learning institution.

2 ELLIOTT-CHANDLER FOUNDATION, INC. SCHOLARSHIP AWARD APPLICATION BIOGRAPHICAL AND CONTACT INFORMATION Applicant s Name (Last, First & Middle) Address Home Phone (Street) (City, State & Zip Code) Sisters (Ages) Birth Date Brothers (Ages) Parent/Guardian s Name (Last, First & Middle) Parent/Guardian s Name (Last, First & Middle) Employer Employer Applicant s Address: Mother s Address: Father s Address: Applicant s Cell: Mother s Cell: Father s Cell: HOUSEHOLD SIZE and INCOME Total Number in Household: Annual Income (Check One) $ 0 - $30, 000 $30,001 $60,000 $60,001 - $90,000 $90,000 and above List any scholarships or grants you have already been awarded. Name of Scholarship Amount/Term

3 HIGH SCHOOL FROM WHICH YOU WILL GRADUATE HS Name Years (From - To) Address (Street) (City, State & Zip Code) Phone Principal s Name OTHER HIGH SCHOOLS ATTENDED HS Name Years (From - To) Address (Street) (City, State & Zip Code) Principal s Name Phone HS Name Years (From - To) Address (Street) (City, State & Zip Code) Phone Principal s Name ACADEMIC RECORD Attach transcript(s) showing high school courses taken and grades received to date and the most recent report card showing courses in progress with grades earned to date. Indicate your scores for any college entrance exam you have taken: ACT Composite SAT: Reading Math Writing CERTIFICATION OF CLASS RANKING BY HIGH SCHOOL REGISTRAR Rank Class Size Current Cumulative GPA is on a scale of: (High School Registrar Signature) (Date) (High School Name)

4 EXTRACURRICULAR ACTIVITIES High School Scholastic Awards or Recognition Honor Societies, Scholarships, Debate Awards, etc. High School Activities and Offices Held Clubs & Social Activities Years Offices Held Music Organizations Years Specialty Athletics Years Varsity Letters

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6 NON-SCHOOL ACTIVITIES Other Activities Years Leadership Roles/Special Achievements Community Organizations Years Leadership Roles/Special Achievements Employer Job Title Dates Employed College Action List the college(s) you have been accepted to and attach a copy of the acceptance letter. (Acceptance pending notices will be accepted): College Name Date of Application SCHOLARSHIP ESSAY

7 In a 1 3 page type-written, double spaced essay (12 point font, 1 inch margins), tell us why winning the Elliott-Chandler Foundation Scholarship Award will be important to you? Include your financial need, educational and career goals, academic plans beyond the baccalaureate level and your vision of where you be in the next 10 years. Do not put your name, the name of your school or any other identifying information in or on your essay. Essays with identifying information will not be considered. RECOMMENDATIONS Include two (2) letters of recommendation. Recommendations should be in separate sealed envelopes on appropriate letterhead from each of the following: o o High School educator from current school on official school letterhead Community or civic leader or professional person who can vouch for your character on organization letterhead All recommendations must be signed and dated. For more information on the Elliott-Chandler Foundation Scholarship Award, visit our web site: Return completed application to: Elliott-Chandler Foundation, Inc. Attn: Scholarship Committee P.O. Box Houston, Texas If you have additional questions or concerns, please contact, Regina Jackson at or mail@elliottchandlerfoundation.org. Selection of Elliott-Chandler Foundation Scholarship Award winners will be based on previously demonstrated attainment of high standards of scholarship and leadership with dedication to the continuous pursuit of excellence. All applications and supporting materials will become the property of the Elliott-Chandler Foundation. PLEASE NOTE: Incomplete or illegible applications shall be discarded at the sole discretion of the Elliott-Chandler Foundation Board of Directors. The Board of Directors also have the right but not the obligation to investigate any information provided by an applicant and should the Elliott Chandler Foundation determine in its sole discretion that incorrect or misleading information has been provided by the applicant, such application may be discarded or if an award has been made, the same may be terminated and forfeited at its discretion. Signed

8 (Applicant) (Date) (Parent) (Date)

9 SCHOLARSHIP APPLICATION INFORMATION The Elliott-Chandler Foundation scholarship(s) will be awarded annually. Scholarship recipients will be notified by /phone. A scholarship recipient shall be eligible to receive a maximum of four (4) scholarship awards providing that the recipient maintains satisfactory academic standards as set forth by the Elliott-Chandler Foundation. The awarded scholarship recipient will be required to enter into the mentoring program as outlined in the Elliott-Chandler Foundation guidelines. SCHOLARSHIP APPLICATION CHECKLIST Applications must be received no later than February 1, Application and supporting materials shall include: A completed Elliott-Chandler Foundation Scholarship Application form. One (1) official copy of high school transcript and most recent grade report from the current school. Documentation of acceptance to institute of higher learning or application pending notification of acceptance. Each scholarship award becomes official upon verification of admission status to the educational institution of choice. Two (2) letters of recommendation on letterhead attached in separate sealed envelopes from each of the following: High School educator from current school on official school letterhead Community or civic leader or professional person who can vouch for your character on organization letterhead