HARTFORD REGION OPEN CHOICE PROGRAM

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Purpose The Mary Carroll-Kennedy Scholarship was launched on June 19, 2002 when Mary Carroll retired from the Hartford Region Choice Program. The award is to provide financial assistance to Hartford Region Open Choice students attending a two-year or four-year college/university. This year s award is up to $2,000. The Marjorie Little Book Award was established to provide financial assistance towards books for the first year of college/university. This year s award is up to $500. Eligibility The Mary Carroll-Kennedy Scholarship will be awarded to a student(s) that meet the following eligibility requirements. 1. Applicant must be at least an Hartford Region Choice Program Open Choice high school graduating senior or junior. 2. Applicant must have maintained a minimum 2.7 cumulative grade point average. 3. Applicant must submit all required application information March 29, 2019. 4. 1 time award. The Mary Carroll-Kennedy Scholarship does not discriminate by age, race, color, national origin, disability, creed, or gender. Selection The recipient will be chosen by the Mary Carroll-Kennedy Scholarship Committee. The Mary Carroll Kennedy Scholarship Committee will determine award recipient by April 19,2018. The recipient will be notified by April 30, 2019. Terms & Conditions 1 time award. 55 Van Dyke Avenue, Hartford, CT 06106 860-524-4010 Fax 860-509-3653 www.crec.org

Application Information Procedure Applicant must submit the following: 1. Complete and signed application form 2. Two letters of recommendation (Use Teacher s Recommendation Form) 3. Personal Statement 4. Official high school transcript showing name of high school (3 rd Quarter) 5. List of other scholastic enrichment programs (Resume if you have one) 6. Verification of Enrollment in a college/university. Deadline for Submission: March 29, 2019 Application Checklist: Complete application, sign and parent sign, if minor Essay 2 Teacher reccomndations Transcript of high school (upto the Senior year third quarter) Letter of acceptance from university/college Please Return To: The Mary Carroll-Kennedy Scholarship Committee (MCKS) c/o Hartford Region Open Choice Program (Roselyn Pacè) 55 Van Dyke Avenue Hartford, CT 06106 Please note: Recipients agree to the release of their name and photo for publicity purposes

MARY CARROLL-KENNEDY SCHOLARSHIP APPLICATION PLEASE CHECK SELECT WHICH AWARD YOU ARE APPLYING FOR: The Mary Carroll-Kennedy Scholarship is to benefit Hartford Region Open Choice students attending a two-year or four-year college/university. Amount of scholarship is up to $2,000. The Marjorie Little Book Ward was established to provide financial assistance towards books for the first year of college/university. This year s award is up to $500. Deadline to submit application is March 29, 2019. Please PRINT or TYPE. If more space is needed, please attach a separate sheet of paper. APPLICANT S INFORMATION NAME: ADDRESS: CITY, STATE, ZIP: TELEPHONE: HIGH SCHOOL: E-MAIL: COUNSELOR: SCHOOL INFORMATION List all academic awards and honors you have received in the last four years. Title Type of Award/Scholarship/Honor Grade/Yr. List all high school extra-curricular activities and offices you held in the last four years. Extra-Curricular Activity Office Grade/Yr.

List all public services, community service, volunteerism activities you have participated with in the last four years. Activity Role Year COLLEGE INFORMATION: Please provide information about the colleges/universities to which you have applied. College/University State Accepted Yet? Intended Major: EMPLOYMENT INFORMATION Please list most recent employment. Employment Information Job Title Time Period

PERSONAL STATEMENT Format for personal statement should be as follows: Typed Double space Times New Roman Font Font size 11 point Top and bottom margins 1 Left and right margins 1 No more than 2 pages Please answer the following question within your personal statement: In thinking about your experience as a participant in the Open Choice Program, please share how your participation in Open Choice has impacted your life and your future goals. Please share specific stories and situations as they relate to your experience. I,, understand that I am a candidate for the Mary Carroll-Kennedy Scholarship and affirm my wish to be considered. Permission is hereby given to my school s administrators to release transcripts of my academic record and other requested information for consideration in the Mary Carroll-Kennedy Scholarship. My signature indicates that all information given on this application is true and correct. I understand that any false information automatically disqualifies me from being considered for this incentive award. Applicant s Name [Print] Date Applicant s Signature Parent s Name [Print] Date Parent s Signature