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1 Danbury High School Scholarship Application Student Name (legal name) Address City Zip Code Telephone Number(s) Student Address Mother s Name Father s Name Application Deadlines Optional Application Review Deadline Monday, November 27, 2017 at 3:00PM Final Application Deadline Friday, December 8, 2017 at 3:00PM **Community service hours acquired after the application deadline will not be put on the application.** FOR OFFICE USE ONLY Application received in office: Optional Review Date: Time: (returned to student on by ) Rec d By: Application Deadline Date: Time: Rec d By: Class Rank GPA ACT Composite Graduation Community Service Hours THIS IS THE LOCAL SCHOLARSHIP APPLICATION
2 PLEASE READ ALL DIRECTIONS CAREFULLY!! Save a copy of the DANBURY LOCAL SCHOLARSHIP document. Complete the application in Adobe Reader and print a copy to submit to the high school office. COMPLETING THE APPLICATION Type everything in the textboxes. If you type more than will fit in the textbox, continue your answer on a separate sheet of paper and attach it to your application. SCHOLARSHIPS By completing this application, you are automatically applying for the local scholarships with open criteria. Check off the scholarships under Selective Scholarships for which you wish to apply. If you are unsure what to apply for, please see Ms. Ward. ACTIVITIES Complete the activity sheet. If you have trouble doing this sheet online, you may complete it by hand. ESSAYS Type the essays on SEPARATE sheets of paper PLEASE DOUBLE SPACE THE ESSAYS. ESSAYS SHOULD NOT BE HANDWRITTEN! Essay questions #1 through #4 MUST be completed by ALL applicants. Essay question #5 is a special essay for those students who would like to apply for the Clifford Bishoff Memorial Scholarship. - When writing your essays, make sure that you write enough to completely answer the essay question. Do not sign the essay. - Answer all of the questions. - Personal statements should be honest and straightforward. - Make sure words are spelled correctly. Use spell check, but do not depend solely on spell check! Proofread! - Do not guess ask Ms. Ward or Mr. Miller if you are unsure. - Print the essays when they are finalized and return them with your completed application by the established deadline. W-9 FORM The last page of this document is a W-9 form, which is needed before a scholarship check can be issued by our treasurer. Everyone applying should print this page and complete it by hand and with student s information to turn in with your application. Information you provide on this form will be used strictly for the purpose of issuing scholarship checks. SCHOLARSHIP RECIPIENT AGREEMENT This agreement is for scholarship awards that are distributed through the Danbury Local Schools Treasurer s Office. The agreement must be signed and on file in the high school office before any scholarship awards can be distributed. APPLICATION REVIEW Your completed application should include the following: - application - check-off sheet for specific scholarships - essays - completed W-9 - activity sheet - scholarship recipient agreement (signed) OPTIONAL APPLICATION REVIEW DEADLINE MONDAY, NOVEMBER 27 TH AT 3:00PM FINAL APPLICATION DEADLINE FRIDAY, DECEMBER 8 TH AT 3:00PM
3 STUDENT NAME MAJOR MINOR (if applicable) LOCAL SCHOLARSHIPS - OPEN CRITERIA American Legion Post 555 Jane Biers Scholarship Biro Manufacturing Blair Scholarship Class of 1967 Scholarship Clifford Bishoff Memorial (complete all essays PLUS #5) Coffin Memorial Danbury Administration Danbury Senior Center Ed Oglesbee Memorial Scholarship Jane Krynock Memorial Joseph J. Kristenek Memorial Kyra s Miracle Fund Scholarship Kristenak Scholarship Krynock Scholarship LaFarge Marblehead Quarry Scholarship Laker Scholarship Lakeside Association Lakeside Women s Club Marblehead Bank Marblehead Peninsula Lions Club Oliver Perry Lodge #341 Ottawa County Board of Realtors Ottawa County Republican Women Peninsula CCL Esther Butchko Memorial Scholarship Port Clinton Rotary (Frank Thompson Memorial) Ned Perruchon Memorial Scholarship (LaFarge) Ron Harger Memorial Richmond Scholarship Class of 1967 John Alan Sauvey & Ernest L. Connors Scholarship SELECTIVE LOCAL SCHOLARSHIPS ART Kathryn Cobbledick Art Scholarship (art related major/minor) ATHLETIC Danbury Athletic Boosters (athletic participation) EDUCATION Danbury Educational Association (major in education) MUSIC SCHOLARSHIP Danbury Music Boosters (2.50 GPA / music participation) DANBURY PTCO Danbury Academic Scholarship (grades / PTCO participation & support) MISCELLANEOUS Marblehead Peninsula Chamber of Commerce (worked for a member of the Chamber)
4 EXTRACURRICULUAR ACTIVITIES ACTIVITY 9 th 10 th 11 th 12 th AIDE (TEACHER / OFFICE / LIBRARY) ACADEMIC CHALLENGE ART CLUB CLASS OFFICER SCHOOL PLAY NATIONAL HONOR SOCIETY KEY CLUB STUDENT COUNCIL YEARBOOK STUDENT TUTOR MUSIC 9 th 10 th 11 th 12 th MARCHING BAND PEP BAND CABARET SPORTS 9 th 10 th 11 th 12 th BASEBALL BASKETBALL CHEERLEADING CROSS COUNTRY FOOTBALL GOLF SOFTBALL STATS - FALL STATS - WINTER STATS - SPRING TRACK VOLLEYBALL WRESTLING MISCELLANEOUS 9 th 10 th 11 th 12 th In the boxes below, please list any additional activities you have participated in that are not listed above.
5 DANBURY HIGH SCHOOL SCHOLARSHIP APPLICATION List your previous work experience (summer employment, as well as during the school year)? Are you currently employed? Yes No If yes, where and do you plan on working during the summer as well? Do you intend to work while attending college to help fulfill the financial need?yes No Please explain in detail the hours involved, summer, or after school employment, and type of job. Do you consider a scholarship and/or employment necessary to enable you to attend college? Yes No If yes, please explain any factors that should be considered. What other sources of financial assistance have you received or do you expect to receive? (grants, loans, or other scholarships)
6 Describe all community and leadership activities outside of school (church, 4-H Club, civic, music, etc.), honors, prizes, or any other recognition received while in high school. If you have numerous activities, please type on a separate sheet. Parental Status: Married Separated Divorced Widowed Single Will either or both parents be able to assist in financial education support? Explain. Father s occupation and place of employment: Mother s occupation and place of employment: Total family yearly income: under $25,000 25,000-50,000 50,000-75,000 75,000 and up To which colleges or universities have you applied? To which have you been accepted? Which college/university do you plan on attending? (If you have been accepted to multiple colleges and your decision depends in part upon financial aid packaging, indicate your preference in order. For example, 1-OSU, 2-BGSU, etc.)
7 What is the estimated yearly academic cost involved? (Visit the college/university website for specific costs.). If you are giving information for multiple schools, use an additional sheet of paper. COST TYPE TUITION ROOM & BOARD (IF APPLICABLE) BOOKS (ESTIMATED) TOTAL TOTAL COST (YEARLY) How many of your siblings live at home? How many siblings are currently attending college? If you currently have brothers/sisters attending college, do they receive Federal Aid? Yes No Do you intend to apply for Financial Aid through the government? Yes No Have you received any scholarships or grants from the college you are planning to attend? Yes No If yes, what is the amount of scholarships offered: Have you received any other outside aid? Yes No If yes, please list the sources and amount of aid below. Is your father or any other member of your family a member of any Masonic Fraternal Organization? Yes No Do you have any family member employed (past or present) at LaFarge Quarry? Yes If yes, what is the name of the employee and his/her relationship to applicant? No Is your father or mother a veteran of the U.S. Military? Yes If yes, which parent and what branch? No Do you have a relative (grandparent, aunt, uncle, parent, etc.) that is a member of the Ottawa County Board of Realtors? Yes No If yes, what is their name and relationship to the applicant. Does anyone in your immediate family (grandparent, parent, sibling) belong to the American Legion? Yes No If yes, what is their relationship to the applicant (not name of person). Is your mother a current member of Peninsula CCL? Yes No
8 SCHOLARSHIP ESSAYS Please answer the questions below in complete sentences and paragraphs. Your answer to each question MUST be typed, double spaced on a separate sheet. Do NOT submit hand-written essays. These questions are a very important part of the application process. Please note the special instruction for essay #5. 1. Using 150 characters or less, please provide a description of yourself. 2. Who has been the most influential person that has had an impact on your future educational goals and/or career? Please explain, in detail, what makes that person an important part of your life. 3. Please describe, in your own words, what character traits you possess that have helped you to overcome personal adversity. 4. Describe your most meaningful achievements in high school and how they relate to and/or have prepared you for your field of study in college. CLIFFORD BISHOFF MEMORIAL SCHOLARSHIP (ADDITIONAL QUESTION) 5. This essay question MUST be completed in addition to the 4 above, if you would like to be considered for the Clifford Bishoff Memorial Scholarship. The Clifford Bishoff Memorial Committee is dedicated to supporting their community. Define the term "Pay It Forward" and tell us how you will incorporate this practice into your life.
9 DANBURY LOCAL SCHOOLS SCHOLARSHIP RECIPIENT AGREEMENT (This agreement is only for scholarships that are paid through Danbury Local Schools and must be submitted with your application to make it complete.) STUDENT NAME Student Initials I understand that by February 1, 2019 I must provide the required documentation for any scholarship award(s) that are paid through Danbury Local Schools. The documentation may include, but is not limited to a tuition bill or book receipt(s) that are equal to or greater than the total amount of the scholarship award(s). Student Signature Date Parent Signature Date
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