Maryland JCI Senate Scholarship

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Maryland JCI Senate Scholarship Each year the Maryland JCI Senate awards two $500 Scholarships to deserving seniors from Maryland high schools. The Maryland winners are chosen based on merit and need. The applications of the two Maryland winners are then forwarded to the US JCI SENATE FOUNDATION for consideration for a $1,000 Scholarship. Information, applications, and instructions for these scholarships are located at the UNITED STATE JCI SENATE FOUNDATION SCHOLARSHIP APPLICATION website at www.usjcisenate.org. Please complete the application and send it by mail to: Cia Marshall Vice President Maryland JCI Senate 96 Beaver Court Rising Sun, MD 21911 Completed applications are due by January 5th, 2018. NO ELECTRONIC SUBMISSIONS WILL BE ACCEPTED. The 2 Maryland winners will be notified and their winning applications will be sent to the US JCI SENATE FOUNDATION for consideration for the $1,000 Scholarship. Any questions please contact Cia Marshall at 443-350-6320 or by email to ciadaycare@gmail.com.

MARYLAND JCI SENATE FOUNDATION SCHOLARSHIP PROGRAM This package contains information and directions for applying to the Maryland JCI Senate Foundation Scholarship Program. Each year $500 grants will be awarded to graduating high school seniors in the state of Maryland, who plan to continue their education at accredited post-secondary colleges, universities or vocational schools. The number of grants awarded annually will be at the discretion of the Maryland JCI Senate Foundation. They must be used for educational expenses in the first year of full-time study. Checks awarded will be made out in the name of the recipient and the educational institution of their choice. The Maryland winners are chosen based on merit and need. The applications of the two Maryland winners will be forwarded to the US JCI SENATE FOUNDATION for consideration for a $1000 Scholarship. Information, applications, and instructions for these scholarships are located at the UNITED STATE JCI SENATE FOUNDATION SCHOLARSHIP APPLICATION website at www.usjcisenate.org. INSTRUCTIONS FOR APPLYING Please read the following points carefully. Failure to comply may be cause for disqualification. All submissions must be typewritten or printed. Included in this application package are all the necessary forms. Supporting documentation of your choice may follow each page as appropriate. Reference letters are limited to five (5) with a maximum length of one (1) page each. Your name must be on the top of each sheet in the package, along with a page numbering system that states page of. All materials MUST be submitted under one cover. Materials sent in multiple mailings will NOT be accepted. Your application must be postmarked no later than January 5, 2018. Mail to: Cia Marshall 96 Beaver Court Rising Sun, MD 21911 Telephone: (443)-350-6320 Email: ciadaycare@gmail.com

Page 1 of MARYLAND JUNIOR CHAMBER INTERNATIONAL SENATE FOUNDATION I. SCHOLARSHIP APPLICATION 1. Name of applicant Date 2. High school 3. Home street address City State Zip Phone 4. Student s e-mail address 5. United States Citizen (check one) Yes No General Information 1. Father s Name Check if deceased 2. Home address Occupation 3. Mother s name Check if deceased 4. Home address Occupation 5. Do you have a Step-parent or Guardian other than your parents? 6. If so, what is their name and address? 7. List in chronological order the names of your brothers, sisters or other persons dependent upon your parents for support: Name Age Relationship College/University you plan to attend: Name Address Have you been accepted? YES NO If yes, attach copy of acceptance letter.

Page 2 of Applicant s Financial Statement The financial contribution of the applicant toward his own education is an important consideration in awarding this scholarship. The committee does not wish to penalize those students whose industry and careful planning have been a consideration in planning college attendance. INCOME : 1. Savings to date $ 2. Expected summer earnings $ 3. Expected contribution from parents $ 4. Earnings from part-time work $ 5. Money from other sources: $ Include gifts from friends, relatives, Education insurance, loans, other Scholarships, etc. TOTAL ESTIMATED INCOME $ EXPENDITURES : 1. Tuition and incidental fees $ 2. Board and room $ 3. Books and supplies $ 4. Clothing $ 5. Incidental expense (travel, recreation) $ TOTAL ESTIMATED EXPENSES $ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Explain any special personal family or financial situation you believe merits consideration:

Page 3 of II. Leadership Positions and Offices List by name and by year ( 9, 10, 11, 12) leadership positions and offices held, and the approximate time commitment each month for school, church, community and volunteer activities. Example: Student council President ( 12; 2.7 hours/month) Hospital volunteer ( 11, 12 ; 25 hours/month) Yearbook editor ( 12; 35 hours/month) Basketball captain ( 12; 5 hours/month) III. Memberships List by name and by year memberships and other participation and the approximate time commitment each month for school, church, community and volunteer activities. Example: Basketball (9, 10, 11; 35 hours/month) Hospital volunteer (9, 10; 25 hours/month) Cheerleader (11, 12; 20 hours/month) 4-H ( 9, 10, 11, 12; 8 hours/month) IV. Honors and Awards List by name and by year the honors and awards you have received during high school. Example: Hospital Volunteer of the Year (11) County 4-H Leader ( 11) Boys/Girls State (11) National Merit Scholar (12) National Honor Society (12) V. Employment List the names and addresses of employers, including family business or self-employment. Indicate whether part-time, summer, full-time, with the hours you worked.

Page 4 of VI. References You may include up to five (5) letters of reference from educators, clergy, employers, and/or community leaders. VII. Transcript A copy of your current high school transcript MUST be included. VIII. Personal Statement Write (type or print) a paragraph of 100 to 300 words, indicating your chosen field of college study. State your reasons for this choice. Included pertinent experiences, activities and accomplishments. This will be the final page of your application. IX. Staple all sheets together, at the upper left hand corner. X. School contact Fill in the following information completely: name of high school address of high school school principal s name XI. SEND TO: Maryland JCI Senate Foundation Cia Marshall 96 Beaver Court Rising Sun, MD 21911

Page of (Last page of submittal) PERSONAL STATEMENT I certify that the facts contained in this scholarship application are true and correct. The Maryland JCI Senate Foundation is hereby authorized to verify any information contained in this application. I understand that any falsification or misrepresentation will result in disqualification. Applicant s Signature Date