JOAN OF ARC MASON MEMORIAL SCHOLARSHIP

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JOAN OF ARC MASON MEMORIAL SCHOLARSHIP Purpose: Eligibility: Deadline: To encourage ongoing academic excellence beyond high school Students selected to receive the Joan of Arc Mason Scholarship may attend school part-time or full-time, and shall be one of the following: A graduating senior of Camas, Washougal, or Stevenson high schools, already accepted at an accredited college or university, within the state of Washington, OR Currently enrolled at an accredited college or university, within the state of Washington, and are a previous graduate of Camas, Washougal, or Stevenson high schools OR Students planning to attend a vocational, technical or career school and are a previous graduate of Camas, Washougal, or Stevenson high schools Your application, letters of recommendation, official sealed transcript and other attachments must be received on or before April 30, 2012. Application and supporting materials must be typewritten and double-spaced in 12-point font. As you fill out this application, please think about what your career goals are, what your community means to you, and what you, as a citizen hope to offer to make your community a better place to live. WHERE DO I SEND MY APPLICATION? Please mail or hand-deliver one complete original application packet to: Community Foundation for Southwest Washington Joan of Arc Mason Memorial Scholarship 1053 Officers Row Vancouver, WA 98661 If you have additional questions about this application, please contact: Anne Digenis Donor Services and Grants Officer Community Foundation for Southwest Washington 360.694.2550 or Anne@cfsww.org WHAT HAPPENS AFTER I SEND IN MY APPLICATION?

Information from the application and attached materials is reviewed by the scholarship committee. Recipients are selected by this committee and award letters are mailed to all recipients. Applicants who do not receive a scholarship are sent non-award notices.

SECTION A - STUDENT INFORMATION Name Address City and State Zip Code Telephone Number E-mail Address List school activities: List academic achievements/honors: List community involvement/service: What were your (student s) earnings on the 2011 1040 tax form? If you had low income or did not work, did you participate in summer classes, internships, volunteer work, tutoring, mentoring, etc? Please explain: SECTION B - COLLEGE, UNIVERSITY, CAREER, TECHNICAL, TRADE OR VOCATIONAL SCHOOL As of September 2012, your year or standing in college will be: Which college, university, career, technical, trade or vocational school do you plan to attend? Have you been accepted? If not, when will you be notified?

This fund supports excellence in education, believing that study, knowledge, work and service to community are important. This scholarship was established to enable this kind of growth in students. With this in mind, what is your area of study and what are the reasons for your choice? Complete the following information based on annual costs: Tuition Books and Fees Room and Board $ $ $ Have you filed the FAFSA form for the 2012/2013 school year? Yes No If yes, what if your EFC amount? $ List scholarships and financial aid you are applying for (or have applied for) and amount of each: List Name of Scholarship, Grant or Other Type of Financial Aid Received? Yes or No Amount If not yet received, date you expect to be notified of decision

SECTION C - FAMILY INFORMATION Father s Name Is your father living? Yes No Father s Occupation Is your father employed? Yes No Mother s Name Is your mother living? Yes No Mother s Occupation Is your mother employed? Yes No Do you live with your parents? Yes No Information about other family members attending school: Name Age School Attending Annual Tuition Unusual Circumstances: If applicable, please describe how and when any unusual family or personal circumstances have affected your achievement in school, work experience, or your participation in school and community activities. How did you hear about this scholarship opportunity? Community Foundation Website (www.cfsww.org) TheWashBoard.Org (www.thewashboard.org) High School Counselor Other:

SECTION D - ATTACHMENTS Essay summarizing your desire for furthering your education, your career goals, and what you hope to contribute to your community as a result of your education to improve the quality of life for its residents. A current official sealed copy of your transcript through last quarter or semester. If currently attending an accredited college or university, you must include a copy of your high school transcript, from Camas, Stevenson or Washougal high schools. Two letters of reference, only being from school personnel. Letters from immediate or extended family members are not acceptable. Attachment #1 completed by a parent or guardian detailing your financial status CERTIFICATION: I acknowledge decisions of the Scholarship Committee and the Community Foundation are final and that this is a competitive selection process. I certify that the information provided is complete and accurate to the best of my knowledge. I understand that intentional misrepresentation is cause for disqualification of the Joan of Arc Mason Memorial Scholarship. I understand that the scholarship advisory committee shall review information on this form and all attachments, and, if asked, I agree to provide proof of information I have given on this form. I give permission for the scholarship advisory committee to contact my references and school officials for additional academic or character reference information. If selected to receive a scholarship, I give permission for a publicity release, including the use of my name and photographic image. Applicant s Signature Date

ATTACHMENT #1 FINANCIAL STATUS Parent or Guardian Please include a brief statement generalizing your student s financial status. Also include details about their summer job potential, on/off campus jobs, savings, etc. Will you, as parents, be helping finance your child s education? Please explain: All information on this application is true and correct to the best of my knowledge. Parent/Guardian Signature Student Signature