Contributions to District Scholarships: Use reverse side if more space is needed. District Name of Scholarship(s)

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GFWC Texas Scholarship Report Form 2016-2018 Annual Reporting Period: January 1 December 31 Club Reporting Deadline: February 1 District Reporting Deadline: February 20 Circle One: Club Report District Report State Report GFWC TEXAS Information about Club/District: Report Prepared By: Date Category Name: Name of Club: Address: _ General Junior Juniorette City District Name State Zip Members in Club _ Clubs in District _ Districts in State STATISTICS: Contributions to GFWC Texas Scholarships: TFWC Scholarship Fund Musical Penny Scholarship Fund Penny Arts Scholarship Fund Billie Lindley McMahon Scholarship Fund Eleanor Tipps Scholarship Fund Simmang Volunteer Award Scholarship Fund Contributions to District Scholarships: Use reverse side if more space is needed. District _ Name of Scholarship(s) List Recipients Contributions to Local Scholarships: Use reverse side if more space is needed. Local Scholarships: Number: Name of Local Scholarship: List Recipients: _ Contributions to Other Scholarships Funds: Amount Donated

REMEMBER! Make copies of this report form and SAVE your original TFWC Directory copy for reporting in 2017! GFWC TEXAS SCHOLARSHIP REPORT FORM For Use by Local Clubs Deadline: February 1 Send one copy of completed report form to District Scholarship Chairman by February 1 along with a brief narrative describing how scholarships are funded. Save one copy for your files. For Use by District Chairmen Deadline: February 15 Send one copy of completed report form along with completed GFWC Texas District Chairman Award List form (attach 1st Place Winning reports ) and a brief narrative detailing statistics and the varying ways scholarships are funded to the Chairman of the TFWC Scholarship Committee. Send one copy of completed report form along with completed GFWC Texas District Chairman Award List form with a summary narrative to the District 1st Vice-President. Retain one copy for your files. For Use by State Chairman Use the cumulative information from all district report forms to create your report and narrative. Compiled information should be used to complete GFWC Texas State Chairman Award List Form. See instructions at bottom of that form. District Scholarship Winners (continued from page 1). Local Scholarship Winners (continued from page 1).

REVISED October 2012 GFWC TEXAS The Scholarship Applicant Summary Form is required and must be submitted by the sponsoring club with the completed application. TEXAS FEDERATION OF WOMEN S CLUBS SCHOLARSHIP APPLICATION FORM Indicate Scholarship Requested TFWC State Scholarship TFWC Penny Arts TFWC Musical Penny TFWC 1903 UT Austin Scholarship TFWC Billie Lindley McMahon TFWC Eleanor Tipps TFWC Simmang Volunteer Award NAME (Last) (First) (Middle) ADDRESS (Street / POB Number) (City) (State) (Zip Code) PHONE DATE OF BIRTH PLACE OF BIRTH YEAR OF HIGH SCHOOL GRADUATION NUMBER OF DUEL CREDITS (If applicable) GPA BASED ON POINT SCALE _ MUST SUBMIT AT LEAST ONE: ACT SCORE SAT SCORE DATE OF COLLEGE GRADUATION IF CURRENTLY A STUDENT (If applicable) COLLEGE YOU ATTEND OR PLAN TO ATTEND DEGREE PURSUING MAJOR MINOR YOUR ANNUAL INCOME FROM WORK OR OTHER SOURCES $ TOTAL AMOUNT OF OTHER SCHOLARSHIP AWARDS EXPECTED $

IF SINGLE, COMPLETE INFORMATION BELOW: FATHER S NAME _ OCCUPATION MOTHER S NAME _ OCCUPATION BROTHERS / SISTERS: NO. AT HOME _ NO. IN COLLEGE? ESTIMATE TOTAL ANNUAL GROSS INCOME OF PARENTS OR GUARDIAN: Circle one: Under $ 20,000 $ 20,000 $ 40,000 $ 40,000 $ 60,000 Over $ 60,000 IF MARRIED, COMPLETE INFORMATION BELOW: SPOUSE S NAME OCCUPATION TOTAL ANNUAL GROSS INCOME: $ NO. OF CHILDREN_ IF SINGLE PARENT, COMPLETE INFORMATION BELOW: TOTAL ANNUAL GROSS INCOME: $ NO. OF CHILDREN AT HOME: IN COLLEGE? NAME AND ADDRESS OF COLLEGE OFFICE THAT SHOULD RECEIVE FUNDS: ADDRESS (Street / POB Number) (City) (State) (Zip Code) THE FOLLOWING INFORMATION MUST BE INCLUDED WITH APPLICATION 1. Fully completed TFWC Scholarship Application. 2. A letter of endorsement from the sponsoring TFWC club. 3. A letter of endorsement from college dean, professor, teacher, principal, counselor or advisor. 4. A letter concerning financial need of applicant or applicant s family. 5. A certified sealed transcript that includes grade point average. 6. A list of extracurricular activities in high school and/or college. Include leadership positions held. 7. A list of volunteer activities. 8. Honors received in high school/college. 9. A personal narrative statement of future plans and/or goals. 10. Enclose a current picture in a sealed envelope. PLEASE PRESENT YOUR APPLICATION IN THE STATED ORDER AND STAPLED IN THE UPPER LEFT HAND CORNER.

SCHOLARSHIP APPLICANT SUMMARY (Completed by Club President or Scholarship Chairman) NAME OF SCHOLARSHIP CLUB NAME _ DISTRICT NAME OF APPLICANT _ DATE OF HIGH SCHOOL GRADUATION GPA ON WHAT SCALE? (HIGH SCHOOL) (PRESENT COLLEGE) GPA_ BASED ON GPA_ BASED ON NAME OF UNIVERSITY / COLLEGE: ANTICIPATED MAJOR / MINOR: FINANCIAL INFORMATION AND SALARY RANGE: LIST OF SIBLINGS OR PARENTS IN COLLEGE: - APPLICANT S GOALS: PERSONAL NOTES: Summary Prepared By: