ROBERT E. LESLIE SCHOLARSHIP PROGRAM

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ROBERT E. LESLIE SCHOLARSHIP PROGRAM STATEMENT OF PURPOSE The Grand Prix Foundation was incorporated in January of 1991 as a non-profit organization whose main purpose is to raise funds through a series of charitable events held in conjunction with the annual Toyota Grand Prix of Long Beach. In addition to donating money to charitable organizations in the Greater Long Beach area, the Foundation Board of Directors established a scholarship program for graduating seniors from the high schools in the Long Beach area. The Robert E. Leslie Scholarship Program, named for former Foundation Director and retired Long Beach Fire Chief, Robert E. Leslie, is intended to provide assistance to qualified students to be used to continue their academic or vocational education at an accredited college or university. The Foundation will award seven (7) scholarships in the amount of $1,500.00 each to the most qualified and deserving candidates from the applications submitted from all the participating high schools. Recipients must be citizens of the United States and residents of Long Beach or Lakewood. Proof of citizenship may be required. These awards shall not be conditioned upon race, color, religion, age, sex, marital status, physical disability, or national origin of the recipient. APPLICATION The application should include the following: Completed Application (2 pages) Digital photo of applicant (head shot preferred) 2 Reference Letters, at least one from a non-school source. Certified Transcripts - Grades 9 through 12 SELECTION PROCESS Selection of recipient shall be based upon an evaluation of a student s academic achievement, academic potential, extra-curricular activity, community service, work experience, educational or vocational goals, and financial need. DEADLINE Please complete and return this form by March 2, 2018 directly to Valerie demartino, Scholarship Chair by email to: demartino@earthlink.net or mail to GP Foundation, 3000 Pacific Ave., Long Beach, CA 90806 Applications must be COMPLETE and RECEIVED by the deadline to be considered.

GRAND PRIX FOUNDATION of LONG BEACH 2018 ROBERT E. LESLIE SCHOLARSHIP PROGRAM APPLICATION COVER SHEET Applicant s Name: First Middle Last Applicants Address: Phone: email: Parent s Phone: email: High School Counselor Counselor s email: I certify that I am a US citizen and a resident of Long Beach or Lakewood (initial ) Academic Institution(s) Applying To: Date: SIGNATURE PLEASE SUBMIT A DIGITAL PHOTO WITH YOUR APPLICATION. APPLICATION DEADLINE: MARCH 2, 2018

Student: Please tell us about yourselves and address the following areas on one or more separate pieces of paper Why would you like to continue your education? What are your personal goals in life and how do you plan to achieve them? Are there any particular circumstances, school experiences, or persons that influence your preparation or motivation to further your education? Tell us about them. What circumstances or problems, if any, have affected your high school education? e.g. money, family responsibilities, educational preparation, health) and how did you overcome them? How do you/your parents plan to pay for college? In what community service have you participated? Tell us what sports, music, clubs or other extra-curricular activities have you participated in; how long did you participate, and in what capacity? What else should we know about you? You may discuss your family life, educational and economic background, or whatever you feel will influence our choice of scholarship recipient. Have you worked (for pay or volunteer) during high school? Tell us about it. What honors have you been awarded in high school?

SAMPLE REFERENCE LETTER FORM Provide this form completed by two individuals (one teacher or counselor and one community member, employer of any individual who can comment about your potential to succeed in college OR submit reference letters from similar persons on their own letterhead). Scholarship Applicant s Name: The person whose name appears above has applied for a Grand Prix Foundation Scholarship. The selection committee would appreciate your answering the questions below in a specific and candid manner, noting in particular incidents that illustrate his/her maturity, initiative and academic potential to succeed in college. Please understand that your recommendation may be made available for the student s inspection, at the student s request, pursuant to the Family and Educational Rights and Privacy Act of 1974 and related laws and regulations. Your Name Position School/Organization: Phone ( ) E-Mail Address City State Zip Explain comments by using complete sentences; avoid responses such as yes or no If your relationship with the applicant does not allow you to make an evaluation of any item, please indicate Not applicable or N/A. 1. How long have you known the applicant? Years Months Under what circumstances have you known the applicant?

2. Based on your knowledge of the applicant, how would you rate his/her academic skills and potential to succeed in college? Feel free to explain. (Example: Outstanding, Above Average, Average, Needs Improvement) A. Academic Achievement: B. Writing Skills: C. Reading Skills: D. Math Skills: E. Academic Potential: 3. Check how you rate applicant s characteristics and motivation. A. Has positive self image: B. Demonstrates leadership capability: C. Self starter, has intellectual curiosity: D. Is willing to work hard to achieve his or her goals: E. Is involved in his or her community: F. Has potential for growth: G. Has financial need: 2

4. What other qualities come to mind that best describe applicant? 5. To the best of your knowledge, does this applicant have a historically disadvantaged background? Yes No 6. Does the applicant have serious financial need? Yes No 7. Are you aware of any current circumstances or problems that might affect applicant s future academic performance (e.g., financial background, family responsibilities, educational preparation, health)? 8. What is your assessment of the student s potential and capability for succeeding at college? 9. Why does this student stand out from the crowd? 10. Please write any additional comments here: Thank you for y our assistance. Date: Signature: Phone # E-Mail NOTE: Please complete and return this form by March 2, 2018 directly to Valerie demartino, Scholarship Chair by email to: demartino@earthlink.net or mail to GP Foundation, 3000 Pacific Ave., Long Beach, CA 90806