Application for Scholarship

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The Jefferson College Scholarship program awards academic excellence through scholarships provided by the Board of Trustees, the local community and the Jefferson College Foundation, Inc. Visit www.jeffco.edu for a list of available scholarships. Application Procedures 1. To be considered for a Jefferson College Scholarship, you must be accepted for admission to the College. 2. Complete and return the 2018-2019 Jefferson College Application for Scholarship. 3. Students must complete the FAFSA and submit all verification documents if required. 4. 2018 High School graduates wishing to be considered for a scholarship are highly encouraged to take the ACT test and have those scores sent to Jefferson College. 5. Return this form to: Scholarship Committee Student Financial Services Jefferson College 1000 Viking Drive Hillsboro, MO 63050-2441 email: finaid@jeffco.edu Application Deadlines 2018 High School Graduates - April 1, 2018 Re-entry/Continuing Students - June 1, 2018 You may submit an application after the deadline listed above. However, only applications submitted by the deadline will be given priority consideration. Late applications are reviewed only after applications received by the deadline are considered. A+ Students and Scholarship Eligibility A+ students who also qualify for a tuition specific scholarship will only be allowed to utilize one tuition scholarship. As a result, A+ students selected for a tuition specific scholarship may be offered a $500 A+ Achievement award instead. 2018 2019 Application for Scholarship Awarding Criteria and Selection of Recipients Scholarship awards are made by the Jefferson College Scholarship Committee and in some instances, the scholarship sponsors. Awards vary in value and criteria and are made according to donor guidelines. Scholarship recipients must have a satisfactory citizenship record. The following criteria are used to select scholarship recipients: 3 Academic achievement (i.e. GPA & ACT score) 3 Financial need* 3 Applicant essay/educational goal statement 3 Extenuating circumstances 3 Extracurricular/community involvement 3 Identified program of study 3 Recommendation by a high school counselor, principal, or teacher * To be considered for a need-based scholarship, you must submit a 2018-2019 Free Application for Federal Student Aid. Available online at www.fafsa.gov. For more information contact your high school counselor or Jefferson College s Office of Student Financial Services. (For the state aid deadline, the FAFSA should be received and processed by the FAFSA processing center no later than February 1, 2018.) Scholarship awards are made throughout the entire year. The 2018-2019 scholarship application will be used to consider students for scholarship awards covering fall 2018 and spring 2019. Some awards include summer 2019. If awarded a renewable scholarship, please be aware that scholarships will not cover the summer after your second year. You will receive an award letter from the College if you are selected to receive a scholarship. Letters are not sent to students who have not been selected to receive a scholarship. Renewal Criteria Most scholarship recipients are expected to maintain full-time enrollment (12 or more credit hours). Scholarship award letters will specify the renewal criteria of the award. It is the policy of Jefferson College that no person shall, on the basis of age, ancestry, color, creed, disability, genetic information, marital status, national origin, race, religion, sex, sexual orientation, or veteran status, be subject to discrimination in employment or in admission to any educational program or activity of the College. In compliance with Federal Rules and Regulations, Jefferson College has adopted a procedure for resolving complaints of discrimination. The procedure is available to any Jefferson College student, employee, or applicant who feels that he or she has been discriminated against in employment, student programs, or student activities. The Americans with Disabilities Act (ADA) Coordinator for students is the Disability Support Services Coordinator, Office Library 110, (636) 481-3169 or 797-3000, ext. 3169 or cplatter@jeffco.edu. The College Coordinator of Title IX is the Vice President of Student Services Office Student Center 205, (636) 481-3200 or 797-3000, ext. 3200 or kharvey@jeffco.edu. Students with concerns regarding any alleged discriminatory act or occurrence falling within the provisions of any of the Federal Rules and Regulations other than ADA as specified above may contact the Vice President of Student Services, Office Student Center 205, (636) 481-3200 or 797-3000, ext. 3200 or kharvey@jeffco.edu. Employees, applicants, or other individuals with concerns regarding any alleged discriminatory act or occurrence falling within the provisions of any of the Federal Rules and Regulations other than Title IX or ADA as specified above may contact the Director of Human Resources, Office Administration 133-E, (636) 481-3157 or 797-3000, ext. 3157 or twelsh@jeffco.edu. 1000 Viking Drive Hillsboro, MO (636) 481-3239 or (636) 797-3000, ext. 3239 FAX (636)789-5103 TDD (636)789-5772 1

The following scholarships have a separate application and are available to recent high school graduates only: Jefferson College Board of Trustees Drama Scholarship Jefferson College Board of Trustees Science Scholarship Jefferson College Board of Trustees Music Scholarship Please contact your high school counselor or Jefferson College Student Financial Services for these scholarship applications. Name V # Last First Middle Telephone Date of Birth Permanent Home Address Street City State Zip County High School Attended Year of Graduation Hi-Set/GED Date Hi-Set/GED Score Are you a US Citizen? Y N Public school district in which you reside Major Area of Study Please describe your educational plans, career interests and goals. (Please fill out essays completely. They will be reviewed by the Scholarship Committee.) 2

High School Extracurricular Activities (This section should be completed if you are a 2018 high school graduate.) 1. Is your high school designated as an A+ High School? Yes No 2. Have you met the criteria for the A+ scholarship? Yes No Please list extracurricular activities (including community involvement and volunteer work) and the year(s) you participated. Name of activity/club/organization/sport Year(s) participated 9 10 11 12 It is the policy of Jefferson College that no person shall, on the basis of age, ancestry, color, creed, disability, genetic information, marital status, national origin, race, religion, sex, sexual orientation, or veteran status, be subject to discrimination in employment or in admission to any educational program or activity of the College. In compliance with Federal Rules and Regulations, Jefferson College has adopted a procedure for resolving complaints of discrimination. The procedure is available to any Jefferson College student, employee, or applicant who feels that he or she has been discriminated against in employment, student programs, or student activities. The Americans with Disabilities Act (ADA) Coordinator for students is the Disability Support Services Coordinator, Office Library 110, (636) 481-3169 or 797-3000, ext. 3169 or cplatter@jeffco.edu. The College Coordinator of Title IX is the Vice President of Student Services Office Student Center 205, (636) 481-3200 or 797-3000, ext. 3200 or kharvey@jeffco.edu. Students with concerns regarding any alleged discriminatory act or occurrence falling within the provisions of any of the Federal Rules and Regulations other than ADA as specified above may contact the Vice President of Student Services, Office Student Center 205, (636) 481-3200 or 797-3000, ext. 3200 or kharvey@jeffco.edu. Employees, applicants, or other individuals with concerns regarding any alleged discriminatory act or occurrence falling within the provisions of any of the Federal Rules and Regulations other than Title IX or ADA as specified above may contact the Director of Human Resources, Office Administration 133-E, (636) 481-3157 or 797-3000, ext. 3157 or twelsh@jeffco.edu. 3

High School Recommendation (This section must be completed if you are a 2018 high school graduate.) This section is to be completed by a high school principal, counselor, or teacher. Please give your appraisal of this applicant including scholastic ability, leadership qualities and citizenship. Please attach an additional sheet of paper if necessary. ACADEMIC INFORMATION Cumulative GPA Signature of Principal/Counselor/Teacher Composite ACT Score Educator Initials 4

Please explain any personal or family circumstances that the Scholarship Committee should be aware of in evaluating your application. (Please fill out essays completely. They will be reviewed by the Scholarship Committee.) Personal Information The following information is useful in matching the appropriate applicant with certain scholarships. (This section is optional.) 1. Ethnic Background 2. Religious Affiliation 3. Are you a single parent? If yes, number of children 4. Will you be continuing your education at another college or university after completing coursework at Jefferson College? If so, please list your transfer plans: I understand that the information on this application will be reviewed by various groups that will select scholarship recipients. In applying for this scholarship, I waive my right of confidentiality. I do I do NOT waive my right of access as provided by Federal law PL 93-380, to confidential letters and statement of recommendation submitted on my behalf relative to this application. Jefferson College may release a list of scholarship recipients to area media sources. I do I do NOT authorize the college to release my name and scholarship information to the media. I certify that the information in this application is correct to the best of my knowledge. Signature of Scholarship Applicant Date 5

Jefferson College returning students use this section to list your community service and club participation: For Internal Use Only RRAAREQ Init. Date RPAAWD Init. Date AW: AM: R/NR Date RUAMAIL: LTR: CERT: 10.17 6