THE DUMITRU GOLEA GOLDY-GEMU SCHOLARSHIP

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THE DUMITRU GOLEA GOLDY-GEMU SCHOLARSHIP Administered by THE ROMANIAN ORTHODOX EPISCOPATE OF AMERICA P.O. Box 309, Grass Lake Michigan 49240-0309 www.roea.org The Dumitru Golea Goldy-Gemu Scholarship (The Goldy Scholarship) is offered annually through The Romanian Orthodox Episcopate of America The number of scholarships awarded to qualified undergraduate students of Romanian ethnic descent is determined by the available capital for distribution. To be considered for the Fall-Winter Term, all fully completed application forms (along with appropriate documents) must be postmarked on or before May 31. Applications received after this deadline will not be submitted to the Scholarship Committee. No extensions will be granted. FACTS SCHOLARSHIP FACTS, REQUIREMENTS & RULES A. The Goldy Scholarship shall be awarded annually, provided there is at least one applicant who meets all the indicated requirements. B. Each scholarship awarded shall be valued at US$1500.00. C. Anyone who has received an award from this scholarship program may also qualify for it in future years in undergraduate studies only, but not for more than a total of four (4) awards. REQUIREMENTS A. The applicant must be of Romanian descent, at least through one of his/her parents, and must be a citizen or permanent resident of either the United States or Canada. B. Each student must furnish written proof of enrollment in the appropriate higher education program: High School Students: A copy of the letter of acceptance from the institution Current Undergraduate Students: A transcript of the students grades at the institution Returning Undergraduate Students: A copy of the letter of acceptance from the institution C. The applicant must be of good character and active in school and/or community. Three letters of recommendation, obtained sealed from the authors, must be included with the application. D. If still in high school, the student preferably must be in the upper one-third (1/3) of his/her graduating class or must be recommended by the principle or designated school official. A high school applicant must have: 1. pursued a college preparatory course; 2. taken, or has arranged to take, a College Entrance Board Examination (CEEB); 3. taken a Scholastic Aptitude Test, either SAT or ACT.

THE DUMITRU GOLEA GOLDY-GEMU SCHOLARSHIP page 2 E. The applicant may already be enrolled as a full-time undergraduate student in a recognized and duly accredited four (4)-year school of higher learning. NOTE: Graduate students are not eligible. F. The applicant may have interrupted his/her education, but is now in the process of reapplying for full-time admission to a school of higher education. G. Each applicant is required to submit a three hundred (300) word handwritten essay on the subject: How my Romanian heritage helps make me a better American/Canadian. H. The applicant must include a recent posed photograph of himself/herself suitable for possible publication. RULES A. Applicants must obtain forms from The Romanian Orthodox Episcopate of America. Requests may be sent along with a self-addressed stamped envelope to P.O. Box 309, Grass Lake MI 49240-0309. Forms may also be available online at www.roea.org or the websites of organizations and institutions affiliated with The ROEA. B. Those applicants currently in high school shall complete his/her part of the Application Form, then submit it to their high school principle or designated official to complete the balance. After he/she has done so, the school official shall return it to the applicant who will be responsible for forwarding it to the Scholarship Committee. C. The student must attend, full-time, a four(4)-year college or university with full government accreditation or a four(4)- year accredited school which trains for the professional arts. NOTE: Neither a two(2)-year community college course, nor a two(2)-year course taken at a four(4)-year institution qualifies. D. The student is required to inform the Scholarship Committee of any and all scholarships already received at the time he/ she applies for The Goldy Scholarship. E. The Goldy Scholarship award check will be sent directly to the recipient. F. Failure to comply with all the Requirements and Rules may be grounds to disqualify any applicant. SEND COMPLETED FORMS AND DOCUMENTS TO: The Goldy Scholarship Committee P.O. Box 309 Grass Lake MI 49240-0309 APPLICATION CHECK-LIST In order to be sure nothing is overlooked, we encourage you to use the simple check-list seen here when preparing your application for submission to the Scholarship Committee. If you have any additional questions, please submit them in writing to the address indicated above. Application Form High School Administration Form (current high school students) Transcript of Grades (current undergraduate students) Letter of Acceptance (high school and returning undergraduate students) Essay Photograph

(APPLICATION FORM FOR HIGH SCHOOL STUDENTS ONLY) THE DUMITRU GOLEA GOLDY-GEMU SCHOLARSHIP Administered by THE ROMANIAN ORTHODOX EPISCOPATE OF AMERICA P.O. Box 309, Grass Lake Michigan 49240-0309 www.roea.org STUDENT RESUME Please print in ink or type the information requested below. After you have completed and signed the form, give it to your proper school official (principal or counselor) to complete the balance. When you receive it back, mail it to: The Goldy Scholarship Committee in care of the above address. NAME SOC. SEC. # LAST FIRST MIDDLE PERMANENT ADDRESS STREET CITY STATE/PROV ZIP/POSTAL CODE PHONE EMAIL CITIZENSHIP DATE & PLACE OF BIRTH OCCUPATION OF FATHER MARITAL STATUS OCCUPATION OF MOTHER MAIDEN NAME OF MOTHER: ROMANIAN DESCENT DATA NAME OF FATHER: MAIDEN NAME OF MATERNAL GRANDMOTHER: NAME OF MATERNAL GRANDFATHER: MAIDEN NAME OF PATERNAL GRANDMOTHER: NAME OF PATERNAL GRANDFATHER: 1 OF 4

If space is needed for any additional data you may have regarding your family s Romanian ancestry, please enter the information on a separate sheet and attach it to this application. COLLEGE/UNIVERSITY YOU PLAN TO ATTAND COLLEGE ADDRESS ENROLLMENT DATE STREET CITY STATE/PROV ZIP/POSTAL CODE INTENDED MAJOR COURSE OF STUDY (ATTACH YOUR LETTER OF ACCEPTANCE) Below, list all scholarships you have received thus far and their amounts. 1. AMOUNT $ 2. AMOUNT $ 3. AMOUNT $ EXTRACURRICULAR ACTIVITIES and HONORS RECEIVED in high school (ie, teams, clubs, memberships, offices held, awards, etc) COMMUNITY ACTIVITIES (ie, religious, civil, organizations, etc) CHARACTER, SCHOLASTIC & ACTIVITY REFERENCES Reference letters are to be in sealed envelopes and submitted with this application. List the names and phone numbers of these three persons (excluding relatives) that the Scholarship Committee may contact. 1. NAME PHONE 2. NAME PHONE 3. NAME PHONE I verify that the information on this form is true to the best of my knowledge. 2 OF 4 SIGNATURE OF APPLICANT DATE

(APPLICATION FORM FOR HIGH SCHOOL STUDENTS ONLY) THE DUMITRU GOLEA GOLDY-GEMU SCHOLARSHIP Administered by THE ROMANIAN ORTHODOX EPISCOPATE OF AMERICA P.O. Box 309, Grass Lake Michigan 49240-0309 www.roea.org HIGH SCHOOL PRINCIPAL OR GUIDANCE COUNSELOR Please furnish the information needed. When the form is completed, return it to the applicant. Also, please attach a transcript of the applicant s academic record (grades 9-12). HIGH SCHOOL ACADEMIC RECORD NAME OF STUDENT HIGH SCHOOL ATTENDED ADDRESS STREET CITY STATE/PROV ZIP/POSTAL CODE COURSE PURSUED ANTICIPATED GRADUATION DATE GRADE POINT AVERAGE CLASS RANK TEST RESULTS CEEB SAT ACT (OTHER) 3 OF 4

SCHOOL RECOMMENDATION COMPARATIVE SCHOLARSHIP RATING STATEMENT OF LEADERSHIP ABILITY STATEMENT OF CONTRIBUTION TO SCHOOL OTHER HELPFUL COMMENTS I verify that the information on this form is true to the best of my knowledge. SCHOOL OFFICER SIGNATURE SCHOOL OFFICER TITLE SCHOOL OFFICER NAME PRINTED DATE 4 OF 4