1 NATIONAL SCHOOL PLANT MANAGEMENT ASSOCIATION 2017 SCHOLARSHIP PROGRAM APPLICATION PACKET The National School Plant Management Association seeks to assist qualified students who are continuing their education by offering scholarships to those pursuing an Associates or Bachelor degree. Any graduating high school senior, college freshman, sophomore, or junior is eligible to apply for a scholarship. A total of $4,000 has been budgeted through the Scholarship Trust Fund for up to individuals based on the selection criteria (financial need, academic achievement, co-curricular participation, community service, and essay response). The individual scholarships may range from $500 up to $1,500 depending on candidate interest, evaluation results, and upon recommendation from the Scholarship Committee. NSPMA Scholarship Program Committee Members Rick Walters, Scholarship Chair Kimberly Keener NJ King William County Public Schools Joe Larrabee - ME 18548 King William Road Wayne Natzel - CT King William, VA 23086 Vince Sodano - NJ
2 2017 NSPMA SCHOLARSHIP PROGRAM APPLICATION Name Address Date Phone (Town, State, Zip Code) E-mail address: Father s (Male Guardian) Name: Occupation: Place of employment (Workplace): Mother s (Female Guardian) Name: Occupation: Place of employment (Workplace): Do you have a family relation to an NSMPA Officer, Board Member, Member, or Representative? YES NO If YES, please provide the name and position: Financial Need: - Please indicate your family s adjusted gross income from their last filed tax return: Under $15,000 $35,000 to $45,000 $15,000 to $20,000 $45,000 to $60,000 $20,000 to $25,000 $60,000 to $75,000 $25,000 to $30,000 $75,000 to $90,000 $30,000 to $35,000 Over $90,000 Total number of family members living at home: Number of dependent children at home: Ages: Number of dependents attending college/post-secondary, including yourself: Other financial considerations, which need to be noted: Student Signature Date Parent/Guardian Signature (if under 18 years of age)
3 Please request your school principal, guidance counselor, college admission or registrar s office provide the information requested in Parts I and II. APPLICANT S NAME: High School Graduation Date (mm/yyyy): I. COLLEGE ENTRANCE EXAMINATION SCORE: (one must be completed) ACT SAT (Copy of official scores must be included with application) II. CUMULATIVE HIGH SCHOOL GRADE POINT AVERAGE: (GPA based on a 4.0 point system-inclusive of Fall 2016 grades. If other than a 4.0 GPA point system is used, please indicate 4.0 equivalency or point system.) CUMULATIVE COLLEGE GRADE POINT AVERAGE: (GPA based on a 4.0 point system-inclusive of Fall 2016 grades. If other than a 4.0 GPA point system is used, please indicate 4.0 equivalency or point system.) (Copy of official transcript from high school and college (if attended) must be included with application) Name of High School/College: City: State: Signature Principal Counselor Admission Officer Date III. COLLEGE CHOICE: College to which you have been accepted or currently attend: Yearly Cost: $ College(s) to which you have applied (list in preference): Yearly Cost: 1. $ 2. $ Anticipated Degree/Profession:
4 IV. SCHOOL ACTIVITIES (may attach additional sheet or student resume) A. Athletic/Sports: B. Business/Leadership: C. Arts/Music/Drama: V. EXTRACURRICULAR ACTIVITIES: A. Humanitarian/Social: B. Religious: C. Work Experience: VI. ADDITIONAL HONORS, AWARDS, RECOGNITIONS:
5 VII. ESSAY In the space provided below (or submit as an attachment), please respond to the following essay topic in a minimum of 300 words: A clean, well maintained, and safe school environment makes a difference in a student s education. The sponsors of this scholarship program currently hold or are retired from school personnel positions in custodial, maintenance, or operational services. We wish you the best in your educational and future endeavors. Application with attachments must be received by April 15, 2017. Recipients will be announced at the NSPMA National Conference April 29-May 2, 2017. Submit to: NSPMA 2016 Scholarship Program c/o Rick Walters, Scholarship Chair KING WILLIAM COUNTY PUBLIC SCHOOLS 18548 King William Road King William, VA 23086