MacArthur OBGYN Scholarship in Memory of Dr. David Wollenman Student Scholarship Application

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1 MacArthur OBGYN in Memory of Dr. David Wollenman Student Application Irving Schools Foundation s are established to assist young people in pursuing their educational goals. Applications must be returned to the Irving Schools Foundation by Thursday, February 28th, REVISED: 1/11/2013

2 SCHOLARSHIP RULES & REGULATIONS ELIGIBILITY AND QUALIFICATIONS To be eligible for a scholarship, a student must be graduating in the spring of the current year from The Academy of Irving ISD, Barbara Cardwell Career and Preparatory Center, Irving High School, MacArthur High School or Nimitz High School and have demonstrated the following: Participation in School and Community Organizations and Activities Self-discipline, Hard Work and Determination Outstanding Achievements in Academics and Leadership A need for financial assistance with higher education ADDITIONAL REQUIREMENTS The student must complete the Irving Schools Foundation application and include two letters of reference, one from a teacher and the other from a non-school source, neither of whom is related to the applicant. A transcript through the last semester of the junior year and a copy of your 2 nd 6- weeks report card must be attached, and the completed application returned to the appropriate counselor by January 11, The application and all attached information become the property of the Irving Schools Foundation. s are limited to those students who have not received a full scholarship. A full scholarship is defined as any source funding 90% or more of a student s tuition, books, and fees. Should a student be awarded a Foundation scholarship and later receive full funding from another source, he/she must immediately notify the Foundation so the Foundation scholarship may then be awarded to the next eligible student. DESCRIPTION OF SCHOLARSHIP Please note: s are not awarded to the recipient in one lump sum. s are paid in installments. MacArthur OBGYN in Memory of Dr. David Wollenman ($1,000) Awarded to a graduating senior who is presently participating in the teen pregnancy program or has in the past. The student must have academic achievement with emphasis on science and math. HOW TO APPLY 1. Complete all portions of this application. 2. Include a copy of all of the required attachments (see your counselor for your report card and transcript). 3. Have your counselor approve your application by signing in the designated verification area on the application. 4. After you complete all of these steps: You or your counselor can send your completed application to the Irving Schools Foundation by Thursday February 28, 2013 (in the IISD Administration building) a. By mail (or counselors send through interoffice mail): P.O. Box Irving, TX b. OR Hand delivered to: IISD Administration Building Irving Schools Foundation Suite W. Airport Freeway Irving, TX c. OR ed:eallen01@irvingisd.net Contact us if you have any issues: Office Hours Monday - Thursday 8:00 a.m. to 5:00 p.m. Friday 8:00 a.m. to 4:30 p.m. **Elspeth Allen (main contact for scholarships) Program and Events Coordinator Fax eallen01@irvingisd.net Crystal Ramirez-Scanio Irving Schools Foundation Executive Director Phone Fax cscanio@irvingisd.net

3 STUDENT APPLICATION No. (ISF office use only) Name (LAST) (FIRST) (Middle) Home Address _ City Sex Zip Telephone Date of Birth Social Security # Middle School attended High School Name of Parent/Guardian Graduation Date _ IMPORTANT: We need to know if you applied for any other scholarships listed below h Please TYPE or PRINT clearly and attach an additional sheet, if necessary. h Submit original application, original letters of reference and THREE (3) complete copy sets of each of these items. Did you apply for any other Irving Schools Foundation s? No Yes (please check all that apply) Barbara Cardwell Future of Education Baylor Medical Center at Irving Beatrice Ponce Garcia Carol Wood Culinary Arts & Small Business Carolyn & David Yarborough Cubbies Against Cancer ***** David H. Brune Memorial ***** Dr. Doug Won ***** Dr. Pepper Dr. John F. Townley Dr. Joseph C. Rice Memorial Erika and German Clouet Memorial Express Employment Professionals Leadership Excellence Fernando Garcia Memorial Hayden Morgan Memorial *** HIPPY Academic ***** Inelda Alaniz Irving Convention and Visitors Bureau Tourism/Hospitality Industry ****** Irving Friendship Foundation ***** Irving Las Colinas Rotary Irving High School Irving Las Colinas Rotary MacArthur High School Irving Las Colinas Rotary Nimitz High School Irving Las Colinas Rotary Singley Academy Irving News/Louise Whitmer Memorial Journalism Irving Noonday Lions Club Jack E. Singley Jerry Roe Memorial Jerry P. Shaw Memorial Jessica Renee Chermley Joe and Mella Ponce Joe Ponce Memorial Football/Track ** John and Margie Stipes John Stipes Motivational John Michael Teal Memorial *** Jordan Wayne Luddeke Memorial ***** Joy and Ralph Ellis $6,000 for Athletes** & ***** Judy Hammond Memorial Athletic ***** Lance CPL. Nazario Serrano Memorial ****** Larry Allen Spriggs Larry Parrish Memorial Las Colinas Cancer Center Foundation by Gregory A. Echt, M.D. ***** Lauralee Hubbard Memorial Lindsey Lear Memorial Loren and Hattie Belle Houtchens **** MacArthur High School A.C.E. Marcella Porter Health & Physical Education Marilyn Polous Community Service ***** MarQualyne Farr Memorial Mary Rudisell Honorary Michael Sigurdson Memorial Mr. Pike s Special Pals Nissan Firefighters 9/11 Memorial Nissan North America Phyllis Lyster Memorial Academic Phyllis Lyster Memorial Vocational Plastronics Perserverance ***** Rebecca Gordon Memorial ***** Richard Bates Sarah Cahill Good Citizen ***** Spc. Josiah Vandertulip Memorial Terry Davis Memorial ***** Tiffani Cain Memorial Time Warner Cable Connect A Million Minds Time Warner Cable Connect a Million Minds Diversity Virginia Pereida Memorial Women s Alliance - Greater Irving-Las Colinas Chamber of Commerce Women of Irving High Woody Schober Music

4 READ CAREFULLY, SIGN VERIFYING ALL OF THE FOLLOWING: I accept the rules and regulations of this application and understand that the decision of the Committee is final. I have included: two (2) letters of reference one teacher and one non-school source (church or community member, employer, etc.) a copy of my transcript through the last semester of my junior school year a copy of 2 nd 6-weeks report card in each copy set (3 sets), plus a complete original. Should I be awarded a Foundation scholarship and later receive full funding from another source, I realize I must notify the Foundation immediately so that the Foundation scholarship may then be awarded to the next eligible student. (See definition of full scholarship under Rules and Regulations. ) I certify that I personally prepared this application for submission. I have taken the SAT yes no ACT yes no Signature of Applicant Date ********************************************************************** Counselor's Verification. I have reviewed this application. Signed by: Title: Date:

5 Background Questions for Applicants Using additional sheets of paper, please answer the questions below, in complete sentences restating the questions so the content stands on its own. Your answer should be in complete sentences unless otherwise indicated or when asked to provide lists of information. Some questions require a minimum amount of words. You should note the point weighting values for question groups since the judges will evaluate your application accordingly. Remember the more information you provide, the more the judges can relate to you as an applicant. DO NOT WRITE ON THIS PAGE - PLEASE USE ADDITIONAL PAPER SECTION ONE GOALS (15 points) 1. In at least 50 words, describe your educational goals. 2. In at least 50 words, describe your career goals. In addition, list colleges or universities you are considering or to which you have been accepted. SECTION TWO ACTIVITIES (25 points) 3. List the school activities in which you have participated. 4. Describe the school activity or activities from your list above to which you feel you have contributed the most and explain why in at least 50 words. 5. List the number of community service hours achieved and the projects you were involved with to earn these hours. 6. List the community service organizations in which you have been involved. 7. Describe the community service from your list above that has meant the most to you and explain why in at least 50 words. 8. Do you have a part time job? Explain SECTION THREE ACHIEVEMENTS (25 points) 9. In at least 50 words, tell which school courses and academic achievements have prepared you for your career goals. 10. In at least 50 words, tell which personal contributions or leadership achievements have prepared you for your career goals.

6 SECTION FOUR PERSONAL STRENGTHS (15 points) 11. Describe your personal strengths (character, educational, interpersonal, etc.) in at least 100 words. SECTION FIVE FINANCIAL NEED (10 points) 12. Explain your financial and/or personal need for scholarship assistance in at least 100 words. Be specific. 13. Provide GPA. SECTION SIX ACADEMIC RECORD (10 points) 14. List attendance (If there were any extenuating circumstances causing you to be absent for an extended period of time from school, please explain).

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