The Hawkins Educational Foundation for Baldwin County Scholarship Application

Transcription

1 The Hawkins Educational Foundation for Baldwin County Scholarship Application *If the application package is not complete, it will not be considered. Application year: 2 0 Address: Date of Birth: First Middle Last _ Important: tification of selection will be communicated via . Please print clearly. Mailing Address: City: Telephone #: State: Zip Cell #: Number of years residing in Baldwin County: Name of High School: Expected Graduation Date: GPA: _ on a pt. scale (unweighted) SAT/ACT: (total score) Official Transcript (through 1st semester, senior year): Enclosed To Follow Anticipated Major / Career Interest: College(s) to which you have applied: Have you ever been convicted of a felony? If yes, please explain: 1

2 Family Information: Father: Living Phone #: Deceased Occupation: Address if different from yours: Mother: Living Phone #: Deceased Occupation: Address if different from yours: Guardian (if you do not live with a parent): Phone #: Occupation: Address: Relationship to Applicant: Spouse (if you are married): Phone #: Occupation: Address if different from yours: Names/ages of siblings in the household or at college but still financially under parent/guardian: How many of these siblings currently attend college? Will you be in the first generation of your immediate family to attend college? 2

3 Does anyone in your family suffer from a serious health condition? If yes, please explain below anything you would like Hawkins Committee members to consider with regard to this question. Work Experience: Are you currently employed? List information about your employment from 9 th -12 th grades in the following table: Date of Employment Place of Employment Name of Supervisor Hours Worked Per Week Your Job 3

4 Community/Volunteer/Church Experience: List information about your community, volunteer, and/or church experience from 9 th -12 th grades in the following table: Date of Experience What Did You Do? Name of Supervisor 4

5 School Activities: List information about your 10 most important extracurricular activities you participated in from 9 th - 12 th grades in the following table: Date of Experience Club or Activity Your Role in Club/Activity 5

6 Income Information: Please provide annual household income: Alabama Adjusted Gross Income (AGI) based on most recent Alabama income tax return (Form 40 or equivalent): $ 125,000 and over $ 100,000 to $124,999 $ 75,000 to $ 99,999 $ 50,000 to $ 74,999 Less than $ 50,000 Are there any financial difficulties or extenuating circumstances your family faces? If yes, please explain below anything you would like Hawkins Committee members to consider with regard to this question. Important te: If selected for an interview, you must bring a copy of pages 1 and 2 of your parents /guardians most recent Alabama income tax return (Form 40 or equivalent) that reflects adjusted gross income. Essay: Please answer one of the following questions in a one page, double spaced, typed essay. All essays should use Times New Roman font, size 12. Additionally, essays should include correct spelling, proper grammar, and appropriate format. The essay should be typed on 8 ½ x 11 inch paper and attached to this application with a paper clip (do not staple). Points will be reduced for essays that do not meet the requirements listed above. Question #1: Write a letter to your future college roommate describing yourself, your college goals, and your goals after college. Question #2: Raymond and Maxine Hawkins desire was to help future generations in Baldwin County by providing scholarships to students. They hoped that their financial assistance would result in an enhanced quality of life for future generations of Baldwin County residents. If you receive a Hawkins scholarship and return to Baldwin County after college, what could you do to enhance the quality of life for the citizens of Baldwin County? 6

7 Applicant and Parent/Guardian Certification: I hereby certify that the information contained in this application is true and correct. I hereby authorize the Hawkins Scholarship Committee to contact any of the individuals or institutions referred to in this application to verify information I have provided, and to make such other investigation of this application as the Committee deems appropriate. I authorize the Hawkins Educational Foundation for Baldwin County to use and disclose any information provided on or with this application for any purpose related to verification of eligibility or continued eligibility for, or the selection and award of, the Hawkins Scholarships. I also authorize any academic institution that I have attended to provide to the Hawkins Scholarship Committee any information about my grades and extracurricular activities that the Committee may request in connection with this application. I understand that scholarship recipients are selected by the Hawkins Scholarship Committee in its sole discretion, and that the misrepresentation or falsification of any information contained in this application package will disqualify me/the applicant from further consideration by or receipt of funds from the Hawkins Educational Foundation for Baldwin County. Signature of Applicant Date Signature of Parent/Guardian Date The Hawkins Educational Foundation for Baldwin County reserves the right to request any additional information or documentation needed to verify eligibility or other application information. Mail completed application with all requested documentation postmarked by deadline date to: Hawkins Educational Foundation P. O. Box Birmingham, AL Mailing Checklist: Completed and signed Application, pages 1-7 Essay Question (one page, double-spaced, up to 200 words) School Transcript with school seal affixed (unless to follow) Up to two reference letters (One must be from school official; one from community leader or employer. NONE from family member.) Please do not staple any items Please ensure pages are one-sided (not copied front/back) If possible, please do not fold items If possible, please mail in an 8 ½ x 11 envelope Important te: The post office box is used exclusively for receipt of scholarship applications and is not monitored throughout the year. For additional information, please visit *If the application package is not complete, it will not be considered. 7