Student Leader Scholarship Application due by June 4, 2013 WROC-TV Attn: Student Leader Scholarships 201 Humboldt St. Rochester, NY 14610 General Description of Award WROC/FOX Rochester and Advantage Federal Credit Union will award five $1000 scholarships to high school seniors in the WROC/FOX Rochester DMA (demographic market area). The scholarships will be awarded to students with demonstrated leadership skills and commitment to community service throughout their high school career. Scholarship Eligibility Must be enrolled in Grade 12 of any public, private, or parochial school in a district within the WROC/FOX Rochester viewing area Student must have applied to an accredited college or university Student must have an overall satisfactory academic standing Student must be involved in demonstrable community service within their community of residence Application Materials Required Completed application form Essay written by the student on the topic stated in the application Two (2) letters of recommendation- one of which MUST be from a school official. Letters may be included with student application or mailed separately directly to WROC- TV (address above) All materials must be sent via US mail and postmarked by the deadline, or hand delivered to WROC-TV offices by 5:00 p.m. on the deadline date. Faxed or e-mailed materials will not be accepted. Materials received after deadline, or incomplete applications not containing all of the above required materials will not be eligible for award consideration. - 1 -
Please type or print clearly: Student Leader Scholarship Application due by June 4, 2013 WROC-TV Attn: Student Leader Scholarships 201 Humboldt St. Rochester, NY 14610 Name Telephone ( ) Home Address Zip Age Birth Date / / Present Grade month day year Parents/Guardians (full name of each) Address if different from above High School Name High School Address High School Guidance Counselor Intended College of Enrollment Please provide GPA, SAT, and ACT scores below, signed by your Guidance Counselor: - 2 -
GPA SAT ACT Composite Gr.9 Math / 800 / 36 Gr.10 Critical Reading / 800 Gr.11 Writing / 800 Guidance Counselor Signature FOR THE FOLLOWING SECTIONS: Please write clearly in ink or submit an attached typewritten resume for these required submissions The judges will consider community involvement & volunteer work closely. Please list the activities below that demonstrate your leadership abilities: Community Educational Sports List any awards, honors, and/or community recognition you have received. - 3 -
Are you employed during the school year? Where Hours/week References Please list the names and titles of your references below, and provide contact information for them if they are not employees of your high school. 1) Title/Occupation 2) Title/Occupation Copy the next page of this application, if necessary, to provide a reference letter format for your two (2) recommendation letters to support your candidacy for selection. You might want to provide your references with this form and a stamped envelope address to WROC. - 4 -
Reference Personal Reference Form Please return to: WROC-TV Student Leader Scholarships 201 Humboldt St. Rochester, NY 14610 This reference letter is to support the application for the following student to the Student Leader Scholarship program. Please comment on the qualities of this student, and indicate in what context you have this student. Deadline for submission is June 4, 2013. Please mail this form, or a typed facsimile, directly back to WROC. Student: School: Print Name Signature Date Telephone - 5 -
Name Essay Respond to the following statement with a maximum of 500 words. Please write clearly with ink or attach a typewritten document. Identify an issue confronting your school or community. Discuss how you would resolve the issue using your current knowledge and experience, and that which you anticipate gaining through future study. - 6 -