Scholarship Application

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The Scholarship Application Application Deadline Date: December 15, 2013 1300 17 th St. Bakersfield, CA 93301 Scholarship Application Deadline Date: 12-15-13

The will award one scholarship to a deserving high school senior pursuing higher education at an accredited college or university in the 2014-15 school year. The amount of the award will be $1000. The scholarship may be used for fees, tuition and/or books or other college-related expenses. The scholarship will be presented at the Kern County Academic Decathlon event on February 1, 2014. The transfer of funds will not occur until the award recipient provides proof of full-time college or university enrollment, which must commence within one year from the date of the award. I. ELIGIBILITY AND CRITERIA To be eligible for consideration for this scholarship, the applicant must: A. Be a high school senior or equivalent at a Kern County high school. B. Have a minimum of a 2.5 grade point average (10-12 grade, -PE). C. Have fully participated in all 10 events in at least two Kern County Academic Decathlon competitions. II. INSTRUCTIONS Careful adherence to the following instructions will provide uniformity among applications and make it possible for the Kern County Academic Decathlon Scholarship committee to evaluate each applicant fairly. Please read all instructions before you proceed with any part of your application. Type or use dark ink in filling out the forms. All parts of the application must be submitted or the application will be disqualified. The parts include: A. Application Form B. Applicant s Letter 1) This one-page letter should elaborate on your background and objectives. Neatness and composition are important. This letter should include: A description of your experience with Academic Decathlon and the division in which you competed. A description of how being involved in Academic Decathlon has helped prepare you for future success. A statement of why you wish to continue your education. A description of your career plans. C. Confidential Statements (2) (request immediately) Academic Decathlon coach (required) Other school representative D. Transcript of School Record (Request your transcript from the registrar immediately.)

III. SUBMISSION OF APPLICATION The materials referred to in A-D above must be submitted to the following address by the deadline date of December 15, 2013: Scholarship Committee 1300 17 th St. CITY CENTRE Bakersfield, CA 93301 Attention: Cathie Morris It is the applicant s responsibility to make certain that all parts of this application are at the above address by the deadline date. If you have any questions, please call: Cathie Morris (Academic Decathlon Coordinator) (661) 636-4593. To ensure that your application is submitted by the deadline date, please request your transcript and distribute the confidential statements immediately. Also, please provide a postage-paid return envelope to your coach and other school representative upon requesting the Confidential Statement.

Personal Information Part A: Scholarship Application Form Name: Address: City/State/Zip: Home Phone #: ( ) Cell Phone #: ( ) Scholastic Information High School(s) (most recent first): Name: Address: Activities/Extracurricular Activities in High School (indicate offices held): Financial Information 1. Anticipated annual cost of tuition, room/board: 2. Education Finance Plans (Please check all that apply): Family assistance Estimated amount (if applicable) $ Summer employment Student loans Work while in college Other (please describe):

SPECIAL CIRCUMSTANCES (if any) FOR CONSIDERATION OF APPLICATION: College Plans To which college(es) have you applied? College Preference: When do you plan to start college? Fall Semester/quarter, 2014 Winter Semester/quarter, 2014 other (explain): Anticipated Major in College (if declared): Confidential Statements Please provide the following information for those submitting Confidential Statements on your behalf: 1. Name of School Official: School Official Title: Telephone: 2. Name of Academic Decathlon Coach: Telephone: Have you included Part B (Applicant Letter) Yes No Have you obtained/requested high school transcript(s)? Yes No Have you requested the Confidential Statements? Yes No Student Signature Date

KERN COUNTY ACADEMIC DECATHLON ASSOCATION Confidential Statement This form should be completed by the Academic Decathlon Coach and a school representative with first-hand knowledge of the applicant. Name of Applicant: School Name: Coach or School Official Name: Official title/capacity with school: Telephone: Email Address: I. Please rate the applicant using the following scale: 5-Outstanding 4-Better than average 3-Average 2-Below Average 1-Does Not Apply 1. General attitude - enthusiasm 2. Self-reliance 3. Leadership potential 4. Academic potential 5. Interest in higher education 6. Teamwork/Collaboration 7. Work ethic II. Please respond to the following questions: 1. How long have you known the applicant? In what capacity? 2. Please describe the strengths and weaknesses (if any) of the applicant. 3. Other comments, including degree of need for financial assistance (if known): Date: Signature: Please mail to:, Scholarship Committee, 1300 17 th St. CITY CENTRE, Bakersfield, CA, 93301. Attn: Cathie Morris DEADLINE: December 15, 2013

KERN COUNTY ACADEMIC DECATHLON ASSOCATION Confidential Statement This form should be completed by the Academic Decathlon Coach and a school representative with first-hand knowledge of the applicant. Name of Applicant: School Name: Coach or School Official Name: Official title/capacity with school: Telephone: Email Address: I. Please rate the applicant using the following scale: 5-Outstanding 4-Better than average 3-Average 2-Below Average 1-Does Not Apply 1. General attitude - enthusiasm 2. Self-reliance 3. Leadership potential 4. Academic potential 5. Interest in higher education 6. Teamwork/Collaboration 7. Work ethic II. Please respond to the following questions: 1. How long have you known the applicant? In what capacity? 2. Please describe the strengths and weaknesses (if any) of the applicant. 3. Other comments, including degree of need for financial assistance (if known): Date: Signature: Please mail to:, Scholarship Committee, 1300 17 th St. CITY CENTRE, Bakersfield, CA, 93301. Attn: Cathie Morris DEADLINE: December 15, 2013