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Personal Information HELEN WASHINGTON MEMORIAL SCHOLARSHIP FUND Scholarship Application Application Deadline: Last Saturday in March First Name Middle Initial Last Name Street Address City State Zip ( ) ( ) Home Phone Cell Phone Email Address Date of birth: Marital Status: Gender Country of Citizenship Family Information: Number of Siblings: Siblings now in College/University: Education Background Academic status List your current grade in school High school Senior College Freshman College Sophomore College Junior College Senior Graduate Student School Information Please list current and past high schools you have attended. If you have graduated list all educational institutions beyond high school that you have attended or are currently attending. Provide the dates of your attendance or the date you graduated. (A current official Transcript must be attached.) Name of School Dates of Matriculation 4 5 Employment Record P a g e

List jobs you have held, if any, and the length of time you worked. If you are working at this time, tell us your employer s name, the job address and provide the name and telephone number of your immediate supervisor. Attach additional sheet, if necessary Place of Employment & Job Title Work Address Supervisor & Phone Dates Worked Honors and Activities: List any awards, commendations, special recognitions, memberships in honor societies, offices or leadership positions you have held. Also describe any school, church, volunteer or community activities in which you have been involved. Attach additional sheet, if necessary Hobbies, Interest, and Special Talents List your hobbies, special interests, talents. Career Goals and Ambitions State your career objective(s) and state how you intend to achieve your objective(s). Attach additional sheet, if necessary Statement of Eligibility/Need State the primary source of your support, e.g., family, employment, SSI. Describe any special circumstances which the LINKS should consider in evaluating your application. Attach additional sheet, if necessary Character and Personal References P a g e

Provide the names, addresses and phone numbers of three adults who know you well, e.g., your teachers, your minister, your Scout leader or any adult person with whom you have worked, studied or who knows you as a volunteer. Do not list any family members or other relatives. [Three reference letters must be attached or emailed before the deadline to support this application.] Name Address Phone Authorization By my signature below I certify that financial assistance from The LINKS would help me achieve my educational goals. If awarded a scholarship I promise that I will use the money only for tuition, books and other expenses directly related to the achievement of my educational goals and objectives. If you are selected we request a recent photo of you so that we may place it on our website and use it as required for documentation. I,, am applying to the Tucson Chapter of The Links, Incorporated for scholarship assistance. I here-by authorize the release of my official transcripts and the release of any financial aid information or data to the Tucson Chapter of The Links, Incorporated, if requested by them. Signature of Applicant: Date: Applications must be received by the Last Saturday in March. Save all required documents as word or.pdf documents and Email to: scholarship@tucsonlinksinc.org OR Mail to: The Tucson (AZ) Chapter of The Links, Incorporated Attn: Scholarship Committee P.O. Box 78 Tucson, AZ 857 Date Application Submitted For Official Use Only: Applicants do not write in this section Date Application Received Scholarship recommendation Yes No Approval Amount $ Explanation of Award/Denial Applicant Notified by Link President : Date Applicant Notified Date: P a g e

CHECKLIST OF ATTACHMENTS ALL THE FOLLOWING MUST BE RECEIVED BY THE LINKS BEFORE YOUR APPLICATION CAN BE PROCESSED. Completed Application Current Official Transcript (s) showing.75 GPA or higher Reference Letters or Letters of Commendation Copy of Acceptance Letter or other verification of your intent to matriculate at a college/university. Students must live in Pima County, Arizona RULES & REGULATIONS OF THE SCHOLARSHIP PROGRAM. The Tucson Chapter of The Links, Incorporated reserves the right to suspend, change or terminate this program at any time.. The interpretation, application and administration of this program shall be determined solely by the Tucson Chapter of The Links, Incorporated and all decisions made by the Tucson Chapter of the Links, Incorporated shall be final.. The maximum scholarship grant to any single recipient in any single academic year shall not exceed the full tuition amount assessed or charged by the educational institution for that year. 4. Scholarships are not transferable to any other persons and are for the sole and exclusive use and benefit of the scholarship awardees only. 5. The scholarship recipient shall immediately notify the Tucson Chapter of The Links, Incorporated upon the occurrence of the following events: a. The student becomes ineligible due to failing grades, drop outs, failure to matriculate, suspension or withdrawal b. The student completes his or her academic work or graduates. 6. Students may reapply for scholarships in subsequent years. Pending available funds, renewal scholarships are awarded at the discretion of The Tucson Chapter of The Links, Incorporated. 7. Scholarships are limited to assistance for a total of four academic years. 8. Scholarships recipients must be female citizens and living in Pima County of Southern Arizona in the United States of African-American descent. 9. Scholarships award decisions are based on the candidates grade point averages, references, recommendations from teachers commendations received, level of involvement in school and community activities, assessment of financial need. Applicants must possess academic ranking of B or higher. 0. ALL scholarship funds are paid directly to the educational institution. Funds for second semester studies are not released until first semester grades are received by LINKS and qualify for that semester.. Scholarship awards must be claimed and/or utilized by recipients within one year of the award.. Incomplete applications or those which are received after the deadline will not be considered. The Tucson Chapter of The Links, Incorporated shall have sole discretion to award its scholarships based on its evaluation of each candidate. 4 P a g e

The Helen Washington Memorial Scholarship Applicants awarded this scholarship must live in Tucson, Pima County, or what we consider, Southern Arizona. Any applicant living in a city north of Marana, Arizona does not qualify for this scholarship. The maximum scholarship granted to any single recipient in any single academic year shall not exceed the full tuition amount assessed or charged by the educational institution for that year. Scholarships are not transferable to any other persons and are for the sole and exclusive use and benefit of the scholarship awardees only. The scholarship application period shall be the first Monday in September through the last Saturday, of March during school calendar year. 5 P a g e