Chris Hunt, President (573) 759-6371 Grover Johnson, Member Mary Nelson, Vice President (573) 759-6187 Carlene McMillian, Member Sheila Gaskill, Secretary (573) 759-3640 David H. Martin, Member Tricia McCray, Treasurer (573) 759-6407 Bland R. Smith, Member Cheryl Stoneking, Member
Guidelines 1. The Dixon Community Scholarship Fund was formed in 1990 with a specific goal of providing scholarship grants to graduates of Dixon High School who intend to further their education at an accredited college or vocational school. 2. Academic standing, while important, is not the only criteria for financial assistance from the scholarship grants. The Scholarship Committee is committed to also look at the students grades, school attendance, conduct, community involvement and desire to commit to the goal of obtaining a college degree. (Minimum of twelve college credit hours per semester must be maintained.) 3. It is also the intent of the Committee to award scholarships to students with limited financial resources whose family income might otherwise disqualify them from federal, state or institutional assistance. They are often the students who excel in later life. 4. The Dixon Community Scholarship Fund and Committee subscribe to all equal opportunity requirements, whether federal or state. All applicants will receive equal and fair consideration of their assistance request without regard to the applicant s sex, race, creed, color or religious preference.
Deadline Information Interview Date: April 27, 2001 Location: Dixon School Administration Building Interview Time: 1:00 p.m. Application Deadline: April 2, 2001 Applicants will receive notice of their scheduled time to be interviewed. A schedule of times will also be available in the High School Principal s office. Please be on time for your interview. If possible, be a little early, 15 minutes or so. If there is a problem with the time you have been given (pre-scheduled work, doctor s appointment, school, etc.), please contact either Trish McCray at 573-759-6407 or 573-759-2027, or Cheryl Stoneking at 573-759-7867 to have your interview time changed. We will try to accommodate everyone to the best of our ability. Scholarships awarded this year will be given at Honors Night. Recipients will be notified by telephone and are asked to be in attendance at Honors Night, if at all possible. Pictures of the recipients will be taken afterwards. Thank you for taking the time to apply for one of the following scholarships: Dixon Community Scholarships Mid America Bank and Trust Ralph Jay Nelson Memorial Scholarship Rue Houck Harris Scholarship (Senior - Boy/Girl) Grover L. Johnson Scholarship Good Luck!!!
Application Instructions We hope you find these instructions informative and helpful in filling out the attached application forms. We ask that you give your answers some thought and that you make them legible! I. EDUCATION 1. List the college to which you have applied or the college that you are currently attending. 2. List your college entrance exam scores: SAT, ACT or both. 3. List your class standing and class size. (high school graduating seniors only) 4. List your current high school or college grade point average. (GPA) 5. List the title of honors courses you have taken, if any. *The word college in this application includes all accredited vocational schools. II. EXTRA-CURRICULAR ACTIVITIES AND WORK EXPERIENCES 1. List those activities in which you have been actively involved within the past three years, such as art, athletics, band, clubs, church activities, community service, debate, drama, school newspaper, scouting, student government, yearbook staff, volunteer work, etc. Please inform us if you have held an office in any club or organization and the length of time (number of years) you have been involved in each activity. 2. List your most recent work experiences, to include full-time or part-time positions, self-employment and summer jobs. Include dates of employment and hours worked per week. If you are a high school senior applicant, don t forget baby-sitting experience, lawn-mowing service, work-study programs, etc. 3. List any conditions that preclude you from working or prevent you from participating in extra-curricular activities, if applicable. 4. Please include all volunteer work and activities. III. SPECIAL AWARDS AND HONORS List any special awards or honors you have received, such as Who s Who Among American High School Students, National Honor Society recognition, Math award, English award, All-State Choir, volunteer appreciation certificates, etc. Don t be shy! If you have been recognized in a special way, we want to hear about it!
Application Instructions Continued IV. FINANCIAL SITUATION V. ESSAY 1. List the number of children living at home or in college. Also indicate how many are in high school and how many are in college. 2. List parents combined taxable income for the calendar year. 3. List any situations concerning the financial status of your family that we should know about. These may include, but are not limited to the following: unusual medical expenses, maintenance of separate households, dependents other than immediate family members, family members with special needs such as handicapped or disabled members, etc. You may include an explanation. 4. List any other scholarships that may be awarded to you for the next academic year. Please name and list the amounts. Please limit your essay to one typewritten page. Essays will be evaluated on the basis of content, grammar and construction. VI. LETTERS OR RECOMMENDATIONS All applicants are required to submit two recommendations. One of which should be from a teacher or professor who has taught you. NOTE: Suggested other sources for recommendations include: sports coach, employer, youth pastor, scout leader, community leader, etc. APPLICATION CHECK LIST 1. Have you read all portions of the application? 2. Have you answered all the questions on the application? 3. Have you obtained a TRANSCRIPT of your grades and attached it to the application? (REQUIREMENT OF ALL APPLICANTS) 4. Have you typewritten your ESSAY on a separate page and attached it to the application? 5. Have you (high school seniors) turned in the School Performance Form to the high school office for completion? Have you later made sure it is completed as well as attached to your scholarship application? 6. Have you included the required number of LETTERS OF RECOMMENDATIONS with the application? REMINDER: All students are required to maintain their scholarship by being in good standing with their school and by being enrolled for at least twelve hours per semester.
Application for Dixon Community Scholarship Scholarships in the amount of $1,000 each are available to graduates of Dixon High School each year from the Dixon Community Scholarship Fund. Half of each scholarship, when awarded, will be paid to the school in which you have enrolled for the fall semester, and the other half will be paid when you enroll for the spring semester. The scholarship money may be used at the school of your choice. Selection of scholarship winners will be by committee and will be based on community and academic accomplishments, completion of application, financial need, recommendations, and a personal interview. Two personal recommendations are required, one from a teacher of your choice and a second from a community citizen of your choice. Your completed application must be submitted only to the Dixon High School Principal or mailed to the Dixon Community Scholarship Fund; P. O. Box 1074; Dixon, Missouri 65459, in a timely fashion to meet announced deadlines. ************************************************************************ Full Name: (First) (Middle) (Last) Home Address: (Street) (City) (State) (Phone) SSN: E-mail: Father s Name: Occupation: Mother s Name: Occupation: Name of School or College you plan to attend or are attending: I Certify that: 1. The information provided in this application is complete and correct to the best of my knowledge. 2. I have read and understand the rules and eligibility requirements set forth by the Scholarship Committee. Applicant s Signature: Date:
General Information Financial Information: Please write the figure that is your family s adjusted gross income on the family s last 1040 United States Income Tax return (Line 33): Total number of family members living at home: ; Number in High School: ; Number in College:. Special Financial Situation:_ List other scholarships or grants for which you have submitted applications and indicate the status of those applications: Name Amount Awarded Denied Undecided Essay: Please attach a one page typewritten essay explaining how you will utilize your college education and your decision of why you are seeking a scholarship from the Community Scholarship Fund. Essays will be evaluated on the basis of content, grammar and construction. List High School/College Activities and Honors: List Community/Volunteer Activities (Dixon or College Community):
High School Student Performance Data Only High School Seniors need to supply this Information The following information must be supplied by the Dixon High School I. Education: 1. Attach the current transcript from the ninth grade through the first semester of senior year. 2. Applicant s current GPA: 3. Class standing: 4. Class size: 5. Number of credits earned by the end of the first semester, senior year: 6. The applicant will graduate with how many years of high school study: 7. List any unusual course of studies unique to the applicant s graduation: II. Attendance: 1. Have the school s attendance policies been a factor with the applicant completing graduation requirements? Comment only if the answer is YES with a short explanation of the circumstances and effort of the student to _ fulf 2. Days missed: Grade: 9th 10th 11th 12th III. Conduct: Answer the following questions only if it applies to the applicant 1. Number of major discipline referrals for the current school year. 2. Number of major discipline referrals that resulted in out-of-school suspension this school year. 3. You may comment on any special or unique conduct situation (within the last three years) that may merit 4. You may comment on any outstanding high school achievements achieved by the applicant that may merit _ add Results from College Aptitude Tests: The applicant has taken the following college entrance exams: Name of Test National Percentile Composite Raw Score / / / / School Signature: Title: Date:
College Student Information Complete only if you are a College Applicant I. EDUCATION 1. What year did you graduate from Dixon High School? 2. What year do you expect to complete your post high school degree? 3. What college are you currently attending? 4. College entrance exam scores: SAT ACT GRE / 5. Please enclose your most recent official college transcript or list of grades. 6. What is your current college GPA? 7. What title of honors courses have you taken, if any? II. COLLEGE ACTIVITIES AND VOLUNTEER WORK: 1. Activity: Academic Year: Position Held: 2. Work experience/job description: Dates Worked: 3. Special conditions or circumstances that prevent you from working or participating in activities: 4. Special awards or honors at college or in the community:
Teacher Recommendation ************************************************************************ To the person completing a recommendation: You have been asked to recommend an applicant for a scholarship from the Dixon Community Scholarship Fund. All information will be handled in a confidential manner by the Board of Directors of the Scholarship Fund and only Board Members will have access to your recommendation. All members of the Board are also excluded from making any recommendations in behalf of any applicant. This completed recommendation must be submitted only to the Dixon High School Principal or mailed to the Dixon Community Scholarship Fund; P. O. Box 1074; Dixon, Missouri 65459, in a timely fashion to meet announced deadlines. Two letters of recommendation are required, one from a teacher and one from a community citizen. ************************************************************************ Name of person making recommendation: Position in School: Name of Applicant: Recommendation should address the following qualities of the applicant: [Please Check] POOR FAIR AVERAGE SUPERIOR EXCELLENT N/A Motivation Dependability Character Cooperation Comments:
Personal Recommendation Form *********************************************************************** To the person completing this recommendation form: You have been asked to recommend an applicant for a scholarship from the Dixon Community Scholarship Fund. All information on this form will be handled in a confidential manner by the Board of Directors of the Scholarship Fund and only Board Members will have access to your recommendation. All members of the Board are also excluded from making any recommendations on behalf of any applicant. This completed recommendation must be submitted only to the Dixon High School Principal or mailed to the Dixon Community Scholarship Fund; P. O. Box 1074; Dixon, Missouri 65459, in a timely fashion to meet announced deadlines. ************************************************************************ Name of person making recommendation: Position in Community: Address: Telephone: Name of Applicant: In what capacity do you know the applicant? [Please Check] POOR FAIR AVERAGE SUPERIOR EXCELLENT N/A Motivation Dependability Character Cooperation Comments: