FOURTH DEGREE PRO DEO AND PRO PATRIA SCHOLARSHIPS FOR COLUMBIAN SQUIRES FOR THE ACADEMIC YEAR BEGINNING SEPTEMBER 2019

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KNIGHTS OF COLUMBUS Making a Difference for Life TO: FROM: RE: SCHOLARSHIP APPLICANT DEPARTMENT OF SCHOLARSHIPS FOURTH DEGREE PRO DEO AND PRO PATRIA SCHOLARSHIPS FOR COLUMBIAN SQUIRES FOR THE ACADEMIC YEAR BEGINNING SEPTEMBER 2019 Scholarships listed above are awarded on the basis of academic excellence. This scholarship program, funded by the Fourth Degree, is available to Columbian Squires in the United States. Fourth Degree Pro Deo and Pro Patria Scholarships are also provided for Columbian Squires applying to The Catholic University of America in Washington, D.C. Applicants indicate their eligibility for a Knights of Columbus scholarship on the university s admission application. You do not need confirmation of your acceptance from a Catholic college or university before filing this application; just indicate your preference on it. In your autobiography, tell us about your family including your brothers and sisters. Include an account of your extracurricular activities, either at school or with any organization and state leadership positions you held. List scholarship honors, awards and any recognition you received for achievement or community service. Indicate any work experience as well. Fill in page 2 of the application. Page 3 should be brought to your Columbian Squires Circle for the Chief Counselor to verify membership. Bring page 4 the application to your school principal or guidance counselor to have the required scholastic information completed. Do not staple anything to the application. Mail the application together with the autobiography, letter of recommendation and grade transcript including the first half of the senior year in one mailing envelope. You will be notified by e-mail when the application has been received in our office. So that your application is received in our office by March 1, 2019, mail it promptly to: DEPARTMENT OF SCHOLARSHIPS KNIGHTS OF COLUMBUS PO BOX 1670 NEW HAVEN CT 06507-0901 1 COLUMBUS PLAZA NEW HAVEN, CONNECTICUT 06510-3326 TEL. 203-752-4000 WWW.KOFC.ORG

KNIGHTS OF COLUMBUS FOURTH DEGREE PRO DEO and PRO PATRIA SCHOLARSHIPS for COLUMBIAN SQUIRES RULES OF ELIGIBILITY The following rules shall govern these scholarships as they pertain to applicants applying to Catholic colleges and Catholic universities. (In applying to The Catholic University of America in Washington, D.C., an applicant for a Fourth Degree Pro Deo and Pro Patria Scholarship needs to complete the university's admission application). 1. An eligible candi for a Fourth Degree Pro Deo and Pro Patria Scholarship for Columbian Squires shall be a member of the Columbian Squires who is in good standing in his circle. Such membership standing shall be verified from the records of the member s local circle and of the Supreme Council. 2. All candis for a scholarship shall be entering the freshman year in an approved Catholic college or university in the United States as a regular, fulltime, matriculated student in a program leading to a bachelor s degree. 3. An official transcript of high school grades, including the first half of the senior year, is to be sent to the Department of Scholarships. 4. Scores on the Scholastic Aptitude Test of the College Entrance Examination Board tests (or the scores of the American College Testing Program) are to be included. 5. An autobiographical essay, containing a description of the applicant s educational objectives, family, extracurricular activities, awards, outsideschool activities and jobs, is to be included. 6. A letter of recommendation from a teacher, counselor, or administrator is to be included. 7. Awards will be made on the basis of academic excellence. The decision of the Committee on Scholarships shall be final. Winners will be notified in May. Names of winners will be published in COLUMBIA. 8. The amount of the scholarship will be determined by the student s educational costs at the college. The maximum scholarship is $1,500 per year, renewable each year of undergraduate study to a total of four years, upon evidence of satisfactory performance and subject to the discretion of the Department of Scholarships. 9. T he scholarship grant will be sent directly to the college. A certified copy of acceptance to the college named must be received by the Department of Scholarships before payment will be made. 10. The final for filing this application, with membership verified by the Chief Counselor, as well as for the supporting documents required in numbers 3, 4, 5 and 6 above, is March 1. Materials submitted in support of the application are not returnable. 11. Address all communications to: Department of Scholarships Knights of Columbus P.O. Box 1670 New Haven, CT 06507-0901 Telephone: 203-752-4332 Fax: 203-752-4103 E-mail: scholarships@kofc.org 1

TO BE COMPLETED BY APPLICANT To protect your security, enter your Date of Birth and Social Security Number manually. Name of Applicant first name middle name last name Address street and number Telephone home Telephone cell area code number area code number E-mail Social Security Number X X X X X Date of Birth month day year I hereby apply for a Knights of Columbus Fourth Degree Pro Deo and Pro Patria Scholarship for Columbian Squires for the academic year beginning: To be used at: Name of College or University month year Address street The information given in this application I affirm to be true and complete. I have read in their entirety the Rules of Eligibility printed on this application and I hereby accept and agree to these rules. signature of applicant I hereby consent to the filing of this application and accept the previously mentioned Rules of Eligibility. signature of parent of dependent son or daughter 2

TO BE COMPLETED BY COLUMBIAN SQUIRES CIRCLE MEMBERSHIP VERIFICATION Name of Circle Mailing Address street and number Name of Chief Counselor E-mail: I hereby certify that name of Squire whose membership number is is in good standing on the records of Circle number. signature of Chief Counselor 3

TO BE COMPLETED BY SCHOOL OFFICIAL Name of School Address street Telephone area code number extension Name of Principal E-mail: Name of Counselor Name of Student Cumulative average Rank in Class / number from top number in class Scores: or SAT CRITICAL READING MATH WRITING ACT ENG MATH READ SCI COMP The above information has been furnished by: signature title DUE DATE IS MARCH 1, Include these supporting documents with your completed application in one mailing envelope: 1. Transcript of HS grades, including the first half of this year, 2. Autobiographical essay, 3. Letter of recommendation Do not send supporting documents under seperate cover: Mail to: Department of Scholarships Knights of Columbus P.O. Box 1670 New Haven, CT 06507-0901 1828 08-13 4

TO BE COMPLETED BY KNIGHTS OF COLUMBUS COUNCIL WHEN APPLICANT S FATHER IS A KNIGHT MEMBERSHIP VERIFICATION Name of Council Mailing Address street Name of Grand Knight E-mail: Complete appropriate section. 1. If applicant is a son or daughter of a Knight of Columbus: Name of Father Membership Number I hereby certify that the above named Knight of Columbus is in good standing on the records of Council Number signature of Financial Secretary 2. If applicant is a son or daughter of a deceased Knight of Columbus: Name of Father Membership Number I hereby certify that the above named Knight of Columbus was in good standing at the time of his death on the records of Council Number signature of Financial Secretary 1828 08-13 5