Chapelwood Foundation New Scholarship Applicant Please fill in completely and submit (along with all requested documentation) via email to the Chapelwood Foundation office at tcannon@chapelwood.org. **Please know that we will not send texts for communication about your scholarship interview, scholarship check, transcripts, etc. ALL communication from the Chapelwood Foundation will be through email, so please regularly check your email so that you are not at risk for losing your scholarship. Personal Information: Name Date Home Address City State Zip Home Telephone Cell Phone Email Address Date of Birth Social Security No. Place of birth Information about your previous Education: High School graduate? (Y or N) GED? (Y or N) Have you previously attended college? (Y or N) Hours attained Name of institution from which degree or certificate was received? Date this degree was awarded? Senior Class Rank Final High School GPA SAT score or ACT score Attach an official copy of your transcript: List your extra-curricularactivities:
Your Work Experience: (list below with the most recent ones first) Company Duties Hrs per week Length of employment How much money have you contributed to your college/continuing education fund? How are you planning to pay for school? Explain: List all other scholarships earned by you (with amounts): Have you applied for other scholarships? If so, list them with amounts: Information about your family: Father s name: Occupation: His taxable income: Attach a copy of last year s form 1040, or W-2, or last year s final paycheck stub Mother s Name: Occupation Her taxable income: Attach a copy of last year s form 1040, or W-2, or last year s final paycheck stub
Did your father or mother attend college? If so, where? What degree was obtained? Father: College Degree? Mother: College Degree? List each brother and sister in your family, with his/her age, and his/her highest level of education: Do you have additional monetary responsibilities such as child support, helping parents with household expenses, etc? Explain fully: Personal Essays: Attach your answers to the following questions to this application: 1. Why do you plan to go to college or vocational school? What are your goals? What do you hope to be doing in five years? How is your school choice going to help you reach that goal? 2. What have you done to make your school and community better over the last four years? Describe the volunteer service(s) you participated in during that time. How did you have an impact? How did each volunteer opportunity affect you? What did you experience? 3. Why should Chapelwood Foundation select you to receive this award? What do you feel makes you the most deserving of the candidates? What have you accomplished in the past year? Recommendations: You need to have ONE TEACHER, COUNSELOR, or PRINCIPAL FROM YOUR HIGH SCHOOL and ONE CHAPELWOOD MEMBER or BOYS AND GIRLS CLUB STAFF MEMBER or OTHER COMMUNITY SERVICES STAFF MEMBER write a letter of recommendation for you. Attach TWO letters of recommendation to this application. Information about your college plans: Give the name and address of the college or technical-training school to which you have been accepted, and enclose a copy of THE ACCEPTANCE LETTER. School name:
Your address at College: Address at college where check is to be sent: Your student ID number (if available) Name of major field of study and degree sought: Hours required to attain this degree. Information about costs: (Please include supporting documentation) Estimated costs for next semester: Total costs: Tuition and fees Books Housing Transportation Food Other (specify) Expected Family Contribution (EFC) if applicable from FAFSA or Financial Aid Office: Do you expect to work? Expected monthly income If you are awarded a Chapelwood Foundation scholarship: Chapelwood UMC Foundation has my permission to: Yes No Photograph me, and I hereby release these photographs to Chapelwood Foundation. Yes No Use any of these photographs taken by Chapelwood UMC Foundation to promote the annual foundation banquet or in other foundation promotional materials to be used within the church. Yes No I understand that giving my permission is voluntary and may be revoked at any time, in writing, to the foundation office.
Please include all items with your application when submitting. By signing and dating below, you are indicating that you have included all required items with this application. Date: Print your name Signature When any of the above information changes, or if you have questions, contact Teresa Cannon at the Chapelwood Foundation Office: By email: tcannon@chapelwood.org By telephone: 713 354-4485 Failure to keep your personal data records accurate and complete could result in your disqualification for any future awards.