INSPIRE Scholarship Application The INSPIRE Scholarship was created by the Community Foundation of Elkhart County to improve the quality of life for Elkhart County residents by providing educational opportunities. Eligible High School seniors will be nominated from each eligible high school in Elkhart County. The INPSIRE Scholarship will award a $3,000 per year scholarship to students pursuing an Associates or Bachelor s degree. The scholarship is for tuition only at any accredited college, university or technical school in the United States. This is a renewable scholarship for either an Associates (2 year) or Bachelor s (4 year) degree program. Scholarship recipients are required to volunteer in Elkhart County for a minimum of 30 hours each year prior to renewal. Eligibility Graduating from an Elkhart County High School Resident of Elkhart County minimum of four (4) years Maintaining a GPA between 2.0 and 3.75 Planning to enroll full time at an accredited college or university Seeking an Associates (2 year) or Bachelor s (4 year) degree Timelines September 1, 2017 Application OPEN December 1, 2017 Application DUE (Applications turned in to High School) December 15, 2017 High Schools report top nominees to Community Foundation January 25, 2018 Nominee Interview Day- 2 Year (REQUIRED) January 26, 2018 Nominee Interview Day- 4 Year (REQUIRED) January 29, 2018 Nominee Interview Day (REQUIRED)- Snow Make-Up Date February 9, 2018 Community Foundation notifies recipients April 28, 2018 Scholarship Awards Brunch (REQUIRED) 101 South Main Street PO Box 2932 Elkhart, IN 46515 www.inspiringgood.org 574.295.8761 1
Application Checklist APPLICATION Fill out pages 5-8 of the following application. Print neatly. See Guidelines for completing community, civic, sports, and extra-curricular activities. TRANSCRIPT (GPA VERIFICATION) Please attach student transcript to this application. ATTENDANCE Print out page 9. Give to your Counselor to complete. PERSONAL EVALUATIONS Print out pages 10-11. Name (2) teachers, counselors, or extra-curricular sponsors who know you well & can evaluate your character. (All evaluations are confidential. Please submit in sealed envelopes that are signed by evaluator.) PERSONAL STATEMENT Each nominee must include a short statement that should be typewritten and 1-2 pages in length. Please answer the following questions: What have you done to make your school or your community a better place? If you receive the INSPIRE Scholarship, you will be receiving a gift from the community. Is it important for you to give back to the community? If so, why and how will it enrich your life? CAREER OBJECTIVES Each nominee must include a short statement that should be typewritten and 1 page in length. Please answer the following questions: What are you passionate about, and how does that tie into your career goals? How do you plan to accomplish your goals? UNUSUAL CIRCUMSTANCES (Attach typewritten unusual circumstances to this form) Each nominee may include a short statement explaining any family or personal unusual circumstances and how those circumstances have adversely affected the student. (Examples are: medical/health problems for self or immediate family member, single parent or single parent household, blended family concerns, recent tragedies such as death of an immediate family member or assault, physical or learning disabilities, incarceration of parent, and any major adverse family financial circumstances. (Please note: if unusual circumstances have been listed, the committee at its discretion may ask for additional information). INTERVIEW Student selected as his/her school s top nominee MUST be prepared to meet with the interview committee at the CFEC. Interviews will last between 20-30 minutes and are scheduled for Thursday, January 25 & Friday, January 26, 2018. Each nominee will be contacted individually to set up an interview time. PHOTO Student selected as his/her school s top nominee(s) MUST be prepared to include one wallet size senior photo. ORIGINAL only. NO copies on paper! Please speak with your HS Counselor if you need assistance with a photo. Please return to your Counselor by: December 1, 2017 2
GUIDELINES For filling out records of activities and leadership. Only include hours between July 1, 2014 November 30, 2017 COMMUNITY, RELIGIOUS, CIVIC ACTIVITIES Include: Teaching Sunday-school or summer bible-school, youth group service projects, missions trips, 4-H activities, service clubs, volunteering at non-profit service organizations (such as: Faith Mission and Teen Court), volunteer coaching, or other volunteer activities. Be sure to include conferences, workshops, and seminars that deal with personal development, leadership training, and/or service such as Rotary RYLA leadership development. (Please be sure to include positions of leadership) Exclude: Attending youth group, church, bible study, Sunday school, attending sports games, plays etc., as an observer; music lessons or other types of lessons; any activity for which you are paid (list under work experience). Any conference or camp for which you paid to attend. SPORTS & OTHER SCHOOL EXTRA-CURRICULAR ACTIVITIES Include: Music groups; drama; clubs; Student Council; NHS; academic teams; peer tutoring; teacher assistant, etc.; tutoring or mentoring before, after or during school hours if giving up a study hall or lunch; sports teams after school hours; after school work on school newspaper or yearbook; FFA; FSA; Prom committee or other school committees; band and orchestra after school hours; plays after school hours. Activities such as student government and tutoring that take place during school day may be included, if verified by counselor. You may also include: seminars, workshops, conferences that deal with personal development, leadership training or service. (Please be sure to include positions of leadership) Exclude: Any graded activity during the school day such as school assistant if receiving a grade; any paid activity such as giving music lessons (list under work experience); any required attendance activity. Paid camps may NOT be included. Hours for sports conditioning (working out) outside of official practice times. 3
SCORING GUIDE Informational tool for helping students and guidance counselors complete and review the INSPIRE Scholarship Application Points Possible Weight % Personal Evaluations 45 15% Attendance 30 10% Participation, Leadership, Service & Work 60 20% Personal Statement 40 13% Career Objectives 50 17% Unusual Circumstances 30 10% Nominee Interview 45 15% TOTAL POSSIBLE 300 POINTS 100% INTERVIEW SCORING GUIDE **This is a sample scoring sheet that will be used by the interview committee to evaluate each nominee. Interviews will last between 20-30 minutes and are scheduled for Thursday, January 25 & Friday, January 26, 2018. Each nominee will be contacted individually to set up an interview time. Students will be evaluated based upon the following criteria (1=Low, 4-5= Average, 9=High): Passion/Energy 1 2 3 4 5 6 7 8 9 Ability to Communication/Articulation 1 2 3 4 5 6 7 8 9 Depth/Thoughtfulness of Responses 1 2 3 4 5 6 7 8 9 Ability to Reach (think on one s feet) 1 2 3 4 5 6 7 8 9 Overall Impression 1 2 3 4 5 6 7 8 9 4
Scholarship Application Student s Name _ Date of Birth Gender (please select): Female Male Race/Ethnicity (please select): American Indian Asian Black Hispanic Multiracial Native American or Other Pacific Islander White Address City Zip E-mail Home Phone Cell Phone _ Number of years you have lived in Elkhart County: Legal Guardian(s) with whom you live: Mother, Step-mother, etc. Father, Step-father, etc. College Information: Please list top two College, University or Technical School choices Intended Course of Study Are you pursing a Technical Certification, Associates or Bachelor s Degree? Please list which one. Please list scholarships (including amounts) you anticipate receiving, which would assist in paying for tuition: 5
Student Pledge: 1. If I receive this scholarship, it is my intent to pursue 2 years (Associates Degree) or 4 years (Bachelor s Degree) of undergraduate study on a full-time basis leading to a technical certificate, associates or baccalaureate degree. 2. I understand the scholarship from the Community Foundation is for tuition fees only, and cannot be applied for any other purpose. 3. I agree to volunteer in Elkhart County for a minimum of 30 hours before June 1 st each year in order to renew my scholarship. I understand that failure to do so will result in the remaining scholarship funds being forfeited. 4. I will keep the Community Foundation appraised annually by June 1 st of my enrollment and academic status during college, by completing and returning any surveys or forms as may be provided by the Community Foundation. 5. I agree to notify the Community Foundation of any updates or changes to my contact information as soon as I am able. 6. My signature indicates permission for my photograph and name to be published in newspapers and other publications if I am an INSPIRE Scholarship recipient. The information in this document is accurate and I agree to comply with the requirements listed above. Student s Signature Parent s Signature Date 6
COMMUNITY, CIVIC & SCHOOL ACTIVITIES: Please list all community, civic or school activities in which you have participated between July 1, 2014 and November 30, 2017. Please include the name of the organization or group, the number of years and your role. If none, please leave this page blank. See example below. EXAMPLE: Faith Mission, 1, Volunteer Soccer, 3, Player and Team Captain Junior Year National Honor Society, 1, Member 7
WORK EXPERIENCE: Please list any PAID work experience between July 1, 2014 and November 30, 2017. Please indicate dates of employment in each job and approximate number of hours each week. If none, please leave this page blank. Any "Work" that was not paid for is considered volunteer work and should be listed under Community, Civic and School Activities. EXAMPLE: Kroger s, Cashier, 1/10/15-5/15/15, 10 hours City of Goshen, Lifeguard, 6/08/16-7/28/16, 30 hours 8
ATTENDANCE FORM: TO BE COMPLETED BY COUNSELOR 2018 Application Student Name: Freshman Year Unexcused Absences Excused Absences Tardies Sophomore Year Junior Year Senior Year Total Number # Other Comments: I verify that the information provided is accurate. Counselor s Signature _ Date 9
PERSONAL EVALUATION #1 Student Name: This evaluation is one of the components of the INSPIRE Scholarship application. It will be graded on a point basis system and added to the student s overall scoring for the final decision making process. Mark an X on the continuum below each characteristic that most adequately identifies the student at the present time. Please mark X clearly in each box; please do NOT place X on vertical lines between descriptions. Is reliable and trustworthy Meets deadlines Works well with others Takes initiative Follows directions Attends school regularly Shows pride in work Follows dress code Demonstrates proficient technical or academic skills Never Occasionally Sometimes Almost Always Always Evaluator Name: _ Name of Organization: Title: _ Contact Number: Relationship to applicant: How long have you known this applicant: Additional comments welcome: 10
PERSONAL EVALUATION #2 Student Name: This evaluation is one of the components of the INSPIRE Scholarship application. It will be graded on a point basis system and added to the student s overall scoring for the final decision making process. Mark an X on the continuum below each characteristic that most adequately identifies the student at the present time. Please mark X clearly in each box; please do NOT place X on vertical lines between descriptions. Is reliable and trustworthy Meets deadlines Works well with others Takes initiative Follows directions Attends school regularly Shows pride in work Follows dress code Demonstrates proficient technical or academic skills Never Occasionally Sometimes Almost Always Always Evaluator Name: _ Name of Organization: Title: _ Contact Number: Relationship to applicant: How long have you known this applicant: Additional comments welcome: 11