MOODY AIR FORCE BASE THRIFT SHOP GRADUATING HIGH SCHOOL SENIOR ACADEMIC SCHOLARSHIP APPLICATION Contact: Moody Air Force Base Thrift Shop Scholarship Chairman Dale Gallagher mdgall@msn.com 520-250-9236 The Moody Air Force Base Thrift Shop is pleased to offer scholarship opportunities to eligible Air Force dependents who are graduating high school seniors who will begin undergraduate studies at an accredited college or university during the 2017-2018 academic school year. ELIGIBILITY/GENERAL INFORMATION 1. The applicant must be a candidate for graduation from high school or certified home school program for the current school year, graduating in 2017. 2. The applicant must be a dependent of any Moody AFB military member: active duty, reserve, retired, deceased, or a remote military member currently on an unaccompanied tour. If the sponsor is retired, deceased, or remote, the member s last duty station must have been Moody Air Force Base. 3. The applicant must have a valid military identification card, and must be enrolled in DEERS. 4. The applicant must have a 3.0 or better grade point average on a 4.0 scale. 5. The applicant must be attending an accredited college or university during the 2017-2018 academic school year. 6. The applicant may not be a family member of the MAFB-TS Scholarship Committee, or of any of the judges. 7. Awards are granted without regard to the USAF military member s rank, or the applicant s race, gender, ethnicity, religion or disability. RESTRICTIONS 1. The scholarship may be used only for payment of tuition and other fees paid through the financial aid office of an accredited college or university of the student s choice. These costs may include books, fees, room or board but may not be used to cover fees from previous academic years, penalty fees or disenrollment fees. 2. Students accepting service academy appointments or FULL scholarships, grants and/or other military thrift shop (MTS) or spouse s group scholarships will not be eligible to receive this scholarship. 3. The recipient shall not be awarded the actual scholarship until he/she has been accepted at an accredited college or university and has provided the MAFB-TS Scholarship Chairman verification of enrollment from the school. The MAFB-TS will mail the scholarship award directly to the school of choice. The recipient must provide the MAFB-TS with the name and address of the school the recipient will attend. 4. The scholarship award, when combined with other scholarships, must not exceed the cost of tuition, fees, books, room and board for the academic year. Any remaining funds must be returned to the MAFB-TS scholarship fund. 5. Applicants may apply for only one MAFB-TS scholarship. APPLICATION INSTRUCTIONS The application and all appropriate paperwork must be dropped off or mailed to the Moody Thrift Shop by close of business (2:00pm) on Friday, March 10, 2017. (If mailed to the thrift shop, the application still must arrive by Friday, March 10, 2017, so make sure to mail it early enough to allow for time-in-transit. We also recommend sending it via Certified Mail so you can ensure delivery). Incomplete or late application materials will not be considered. Please retain a copy of all documents, as application packets will not be returned.
APPLICANTS 1. Complete the application form and essay. 2. Have your guidance counselor complete the counselor s recommendation form. 3. All dependents must submit verification of DEERS enrollment. This can be the DEERS form 1172 (or) the Verification of Eligibility for MAFB-TS Scholarship Form included in this packet. 4. All dependents must submit verification of their sponsor s employment at Moody AFB. This can be a copy of orders (or) the Verification of Eligibility for MTS Scholarship Form included in this packet. 5. Dependents of retired or deceased members must submit ONE copy of DD form 214. PLEASE HIGHLIGHT THE BLOCK THAT SHOWS YOU RETIRED FROM MOODY AIR FORCE BASE. 6. Submit ONE (1) letter of recommendation from a person not related to the applicant. 7. Submit ONE (1) copy of the applicant s High School Transcripts (can be an unofficial copy). 8. Complete and submit the Statement of Understanding signed by the student and his/her sponsor. 9. Ensure that your name is on all supporting documents. APPLICATION DROP OFF/ARRIVAL DEADLINE: Friday, March 10, 2017 by 2:00pm DROP OFF/MAIL APPLICATION MATERIALS TO: MOODY AFB THRIFT SHOP ATTN: Dale Gallagher, Welfare/Scholarship Chair 843 ST. GEORGE STREET MOODY AFB, GA 31699 AWARD NOTIFICATION: You will be contacted in April of 2017 if you have been selected for the award.
MOODY AFB THRIFT SHOP GRADUATING HIGH SCHOOL SENIOR SCHOLARSHIP STATEMENT OF UNDERSTANDING (Please read carefully and sign) I certify that the information in this application is accurate to the best of my knowledge. I further certify that the following statements are true and should I accept a MAFB-TS award, I will not be, and am not currently, in violation of any of the following restrictions. 1. All funds received shall be applied to tuition and fees at an accredited college or university for the 2017-2018 academic year. These funds will be deposited with the financial aid office at the school of your choice. IT IS THE STUDENT S RESPONSIBILITY TO NOTIFY THE MAFB-TS OF WHEN AND WHERE TO SEND THE MONEY. 2. Students accepting service academy appointments or other FULL scholarships or grants will relinquish the 2017-2018 High School Senior s Academic Scholarship and notify the MAFB-TS chairman as soon as possible. 3. I will not accept another Thrift Shop scholarship, or a scholarship from another military officers or enlisted spouses organization from a different location. 4. If selected as a winner, I understand I will not receive the actual scholarship until I have been accepted at an accredited college or university and have provided the MAFB-TS Scholarship Chairman verification of enrollment from my school. 5. I understand that the MAFB-TS Scholarship Committee reserves the right to correspond with the selected school s financial aid officer concerning the appropriate use of this award. Should questions or concerns arise, the Scholarship Committee reserves the right to withdraw unused funds until my standing is clarified to their satisfaction. 6. I agree to the use of my name and picture concerning this award in local publications. 7. I meet all eligibility criteria. Signature of Applicant: Date: Signature of Sponsor: Date:
MOODY AFB THRIFT SHOP GRADUATING HIGH SCHOOL SENIOR SCHOLARSHIP APPLICATION (You may attach additional sheets, if necessary. Print clearly or type.) APPLICANT S INFORMATION: Name: Last Four (SSN): Mailing Address: City: Zip Code: Phone: Email Address: Date of Birth: SPONSOR S INFORMATION: Sponsor s Name and Grade: Sponsor s Status (circle one): ADAF RetAF Deceased Guard Reserve Duty Phone: Organization (Date and last assignment if retired): Organization s address: Sponsor s home phone number: Sponsor s home address (if different from applicant s): How did you hear about our scholarship? (Moody Volunteer, Facebook, email, word of mouth, guidance counselor): Did you, or will you apply for another spouse club or thrift shop scholarship? If so, which spouse club or thrift shop?
High School(s) Attended grades 9-12: Name Location Dates of Attendance GPA School Achievements/Activities (Clubs/Band/Athletics and Awards earned in these): Club/Activity/Organization Office(s) Held (if any) Dates of Involvement Community Activities and Awards (outside of school - Church/Scouts/Community Service/Volunteer): Activity Office(s) Held (if any) Dates of Involvement/Hours Logged
Employment (after school and/or vacation): Place of Employment Job(s) Held and Average Number of Hours Worked per Week Dates College or University you wish to attend: 1 st Choice 2 nd Choice On separate sheet of paper, please answer the following essay topic: Think of a significant experience you have had or a risk you have taken, or an ethical dilemma you have faced, and describe it s impact on you. The essay should be typed and double-spaced, and at least 500-700 words in length. Do not use your name, school, position or other identifiers in the essay. Include the last four of your SSN in the top right hand corner of your essay.
MOODY AFB THRIFT SHOP GRADUATING HIGH SCHOOL SENIOR SCHOLARSHIP APPLICATION COUNSELOR S RECOMMENDATION FORM (The applicant s high school counselor must complete this form.) Applicant s Name: Class rank: out of Percentile Rank: Current Cumulative Grade Point Average: (weighted) (unweighted) SAT Scores: Verbal (possible 800) Math (possible 800) Combined Score Percentile for college-bound students in the nation. Composite percentile for collegebound students in the nation. ACT Composite Score (possible 36): Number of Weighted/AP Courses: Number of IB Courses: IB Diploma Candidate? Do you recommend this applicant for the Moody Thrift Shop Scholarship? Yes No Counselor s comments (optional) Name of Guidance Counselor: School name & address: Counselor email: Counselor phone #: Signature: Date
MOODY AIR FORCE BASE THRIFT SHOP GRADUATING HIGH SCHOOL SENIOR SCHOLARSHIP APPLICATION (Contact: Dale Gallagher, MAFB-TS Scholarship Chair, mdgall@msn.com, 520-250-9236) o One copy of the application. Checklist o One copy of the essay. o One copy of a letter of recommendation. o One copy of high school transcript(s). o One copy of the Counselor Recommendation Form. o One copy of Verification of DEERS enrollment. (This can be DEERS form 1172 (OR) the Verification of Eligibility for MTS Scholarship form.) o Retired or Deceased Sponsor: include one copy of DD form 214 (PLEASE HIGHLIGHT THE BLOCK THAT SHOWS YOU ARE RETIRED FROM MOODY) o One signed Statement of Understanding. o Make sure the last four of your SSN is on all documents. APPLICATIONS WITHOUT ALL SUPPORTING DOCUMENTS WILL NOT BE ACCEPTED! Due Date March 10, 2017 by 2:00pm
Date: MEMORANDUM FOR RECORD TO: Moody Thrift Shop Scholarship Chairperson SUBJECT: Verification of Eligibility for MAFB-TS Scholarship This memorandum is to verify that the individual meets the criteria as listed below 1. The applicant must be a dependent of a Moody AFB Military member to include active duty, reserve, retired, deceased, or a remote military member currently on an unaccompanied tour. If retired, deceased, or remote the member s last duty station must have been Moody AFB. 2. The applicant must have a valid military identification card and must be enrolled in DEERS. 3. Applicant Information: Name: Date of Birth: Sponsor s Name: Sponsor s Squadron/Unit: Signature of Sponsor s Supervisor: Printed Name of Supervisor: Supervisor s Squadron/Unit: