MAKING A LONG STANDING COMMITMENT TO EDUCATION AND INVESTING IN FUTURE LEADERS

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Ronald McDonald House Charities of Greater Las Vegas Alumni Scholarship Program MAKING A LONG STANDING COMMITMENT TO EDUCATION AND INVESTING IN FUTURE LEADERS Ronald McDonald House Charities (RMHC ) of Greater Las Vegas, with support from RMHC, Inc. & McDonald s Owner/Operators of Greater Las Vegas, is proud to offer continuing scholarship opportunities to students who have previously received scholarships through the RMHC of Greater Las Vegas Scholarship Program. Application Deadline: March 10, 2017

BACKGROUND Ronald McDonald House Charities (RMHC ) of Greater Las Vegas is a 501(c)(3) nonprofit organization that creates, finds and supports programs that directly improve the health and well being of children in our community. With education costs spiraling ever higher, a college education is beyond the financial reach of many outstanding students. A partnership between RMHC and its local Chapters opens the door to higher education for students who face limited access to educational and career opportunities. The RMHC scholarship program seeks to invest in students who are exemplary role models in their communities and have the initiative to fulfill their educational goals. RMHC s goal is simple: to identify and invest in future leaders. LOCAL SCHOLARSHIPS Since 1999, RMHC of Greater Las Vegas has awarded over $4 million in scholarships to more than 1,690 high school seniors in Clark & Nye counties. The RMHC Alumni Scholars Scholarship Program began offering scholarships to past RMHC Scholarship recipients in 2008. To date, the Alumni Program has awarded more than $460,000 to returning college students. The Las Vegas Review-Journal and McDonald s Owner/ Operators of Greater Las Vegas help support the Program by donating a portion of every Review-Journal newspaper sold at participating McDonald s restaurants. ELIGIBILITY All applicants must meet the following criteria: be a past recipient of the RMHC of Greater Las Vegas Scholarship Program. currently be enrolled at an accredited two-year or four-year college, university or vocational/technical school with a complete course of study. have a minimum 3.0 cumulative college GPA (high school GPA s NOT considered). submit a complete signed application with all required documents. be a legal U.S. resident. TERMS & CONDITIONS Eligible applicants must sign and submit a complete application with all required documents, postmarked no later than March 10, 2017, or their application will not be reviewed. Applicants must disclose other scholarship programs for which he/she has applied. Applicants must be willing to provide additional verification of all information in scholarship application upon request. Award amounts vary from $1,000 to $2,000 and may ONLY be applied to tuition, fees, and books. Recipients must attend an accredited college or university or vocational/technical school in the 2017 academic year as a full-time student. (12 credit hours min.) The total award amount is sent with the intitial request. It is up to the recipient to decide how funds should be divided over the Fall and Spring semesters. TERMS & CONDITIONS (cont d) Recipients must provide information regarding financial aid and additional scholarships they have received. Recipients must submit verification of enrollment and fulltime status before checks are sent. Funds are paid via check directly to the accredited institution in which the student is enrolled, and are NOT paid to or reimbursed to any student at any time. SUPPORTING DOCUMENTS The following documents are REQUIRED: Certified college transcript(s) to include cumulative GPA (Fall 2016 semester grades must be represented), total credit hours (or equivalent), and courses taken. A personal statement from the applicant, no more than 3 pages, that answers the following: (a) How has the RMHC Scholarship helped you achieve your educational goals? (b) What are your current career goals and how do you plan on achieving these goals? (c) Provide information about any community involvement and/or extracurricular activities you ve been involved in at college. Additional information, such as unique personal or financial circumstances should also be added. One letter of recommendation from a professor, coach, employer, community leader, or other school official (high school references will not be considered). The letter should be personalized and detail the applicant s (a) achievements, (b) leadership abilities, (c) career pursuits and (d) community involvement. All applicants must submit the most recent copy of the IRS Form 1040 filed by his/her parent(s) or guardian(s) used to document total income. CERTIFICATION AND RELEASE All applicants and, where appropriate, their parent or guardian, must sign the attached application, certifying that all information provided is true and complete to the best of their knowledge. If it is later determined that information contained in the application is false or misleading, final awards may be rescinded. Upon submission of the completed application, applicants grant RMHC and McDonald s the right to use any information contained in the application for the purpose of promoting and publicizing the Program, or as legally required or permitted by law. APPLICATION SUBMISSION Completed applications with all required documents must be postmarked no later than Friday, March 10, 2017 and sent to: RMHC of Greater Las Vegas Alumni Scholarship Program 2323 Potosi St. Las Vegas, NV 89146 Incomplete applications will NOT be considered. Applicants will be notified of award decisions in May 2017. Questions? Call (702) 252-4663 or email scholarships@rmhlv.org. 2 RMHC of Greater Las Vegas Alumni Scholarship Application

Application Due: March 10, 2017 RMHC of Greater Las Vegas 2017 Alumni Scholarship Application APPLICANT GENERAL INFORMATION Please Type Or Print NAME PERMANENT MAILING ADDRESS St. # Street Name or RFD Apt. or Unit # City State Zip MAILING ADDRESS AT SCHOOL (IF DIFFERENT) St. # Street Name or RFD Apt. or Unit # City State Zip CELL PHONE # ( ) HOME/ ALTERNATE PHONE # ( ) EMAIL DATE OF BIRTH / / MALE FEMALE Day Month Year FAMILY INFORMATION Applicant s Place of Birth: City ST County Father s Name: Mother s Name: Alternate phone number / contact name: What is your Ethnicity/Nationality? (optional) American Indian/Alaska Native Asian African American Black Caribbean Hispanic/Latino Native Hawaiian/Pacific Islander White/Caucasian Other Are you a legal U.S. resident? Yes No Are you a first generation student from your family to attend a college or university? Yes No Are you, or an immediate member of your family, an employee of McDonald s*? Yes No * McDonald s employees who meet all scholarship requirements ARE eligible to apply. 3 RMHC of Greater Las Vegas ALUMNI Scholarship Application

ACADEMIC INFORMATION Name of the school you currently attend: MAJOR/FIELD OF STUDY: TOTAL CREDIT HOURS COMPLETED: CUMULATIVE COLLEGE GPA: TOTAL CREDIT HOURS REQUIRED FOR DEGREE: ANTICIPATED GRADUATION DATE: Name of school(s) you have attended since graduating high school (if different from above): Name of school you plan on attending in the Fall of 2017 (if different from above): What year did you graduate high school? Name of High School: COMMUNITY INVOLVEMENT SCHOOL / EXTRACURRICULAR List up to six activities you have had the most involvement in the last four years (school clubs, student govt., publications, varsity or club sports, theater arts, Scouting, 4-H, etc.) Please do not use acronyms. Activity/Group Years Involved Highest Position Name & Phone # of Advisor COMMUNITY / VOLUNTEER SERVICE List up to six agencies or organizations in which you have participated WITHOUT PAY during the last three years (religious groups, hospital volunteer, cultural activities, outreach programs, etc.) Please do not use acronyms. Agency/Organizatoin Years Involved Type of Work Name & Phone # of Advisor WORK EXPERIENCE List any work experience you have had (food server, babysitting, lawn mowing, office work, etc.). Employer Name Start Date End Date Highest Position Name & Phone # of Supervisor 4 RMHC of Greater Las Vegas ALUMNI Scholarship Application

PARENT / GUARDIAN FINANCIAL DATA (required) 1) Parent/Guardian s adjusted gross income (FORM 1040) 2) Parent/Guardian s yearly untaxed income and benefits Please indicate source: Social Security AFDC Child Support Other 3) Total cash, checking, savings, and cash value of stocks (exclude retirement plan funds, IRA, 401K) 4) Total number of family members living in the household and primarily supported by the income listed on line 1 5) Total # of family members attending college at least half-time during the next school year (2017-2018), including applicant 6) Marital status of parent or guardian: Married Divorced Separated Widowed Single CERTIFICATION and AUTHORIZATION All of the information that I have provided in this application and in the enclosed letters is accurate and complete to the best of my knowledge. I understand and acknowledge that providing false or misleading information in any aspect of this application or any enclosed letters may lead to the rescinding of any award that I may have received. I authorize Ronald McDonald House Charities and/ or McDonald s to verify any of the information contained herein including after the awarding of any scholarship. I certify that I am currently enrolled as a full-time student at an accredited two- or four-year college or university or vocational/technical school and am eligible to receive scholarships granted under the Program. I confirm that I will continue to attend an accredited two- or four-year college, university, or vocational/technical school for the 2017-2018 academic year. I understand that should I be selected for a scholarship, I (or my parent/guardian on my behalf) will be required to execute a talent release form prior to the award of any scholarship. I may also be required to participate in media events at selected times to promote the Program and agree that my attendance at such events (unless excused for cause) is a condition of being awarded any scholarship. Failure to execute any talent release or failure to appear at any events (unless excused for cause) may lead to revocation of any award. I hereby authorize Ronald McDonald House Charities or any of its Local Chapters and McDonald s to use any information contained in this application for the purpose of promoting and publishing the Program or as legally required or permitted by law. AUTHORIZATION FOR RELEASE OF RECORDS In accordance with the provisions of the Family Education Rights and Privacy Act of 1974, permission is hereby given to applicant s school officials to release the applicant s secondary school record and other requested information for consideration in the Program. APPLICANT S SIGNATURE DATE PARENT / GUARDIAN SIGNATURE DATE (required if applicant is under 18 years of age) BE SURE TO INCLUDE THE FOLLOWING DOCUMENTS WHEN SUBMITTING THIS APPLICATION OR IT WILL NOT BE REVIEWED: Personal statement Parent/guardian s IRS form 1040 Letter of recommendation Official College Transcript with GPA, Credit Hours, and Degree Requirements Questions? Call (702) 252.4663, visit www.rmhlv.org or email scholarships@rmhlv.org 5 RMHC of Greater Las Vegas ALUMNI Scholarship Application