The Republican Women of Muscogee-Harris County
SCHOLARSHIP APPLICATION
has been established
in order to provide financial support to outstanding high school senior students in our community. The Scholarship will be awarded to deserving young adults pursuing careers in any academic field with preference given to civic and social studies. Preference may also be given to applicants with outstanding demonstration of civic mindedness.
Applications will be accepted beginning January 15, 2012 and ending May 1, 2012.
RETURN APPLICATIONS TO:
Republican Women of Muscogee-Harris County
Attn: Scholarship Committee Chair
2733 Camille Drive
Columbus, GA 31906
E Mail address: scholarship@RWM-HC.com
SCHOLARSHIP CRITERIA
ELIGIBILITY:
1. Scholarships will be available to eligible applicants pursuing degrees.
2. Candidates for a Scholarship must provide the following:
A. Completed application.
B. Proof of acceptance into an accredited school.
C. High School Transcripts (originals) which show at least a B average in previous academic work. Must be originals.
D. Three (3) signed reference forms sent directly to the Scholarship Committee to the address shown on the form by the individual who provides the reference. References may be from high school teachers, college professors, clergy, volunteer organization supervisor's and previous employees—NOT personal friends, or relatives.
4. Candidate must participate in a personal interview with the Scholarship Committee.
CONDITIONS:
1. $1000.00 scholarships will be awarded annually.
2. Each scholarship recipient will sign a promissory default agreement with The RWM-HC. Applicants under the age of 18 are required to have a legal guardian as cosigner.
3. Cancellation of the scholarship will occur if:
A. The student fails to maintain a passing grade in related academic work.
B. The student fails to complete the program.
4. Repayment of all scholarship monies will be due within 60 days after cancellation.
5. Students must furnish to the Scholarship Committee a transcript of grades following each semester/quarter of school. (Must be originals)
6. Students may receive a maximum of two scholarships.
7. The decision of the Scholarship committee is final.
All correspondence (references, letters, transcripts, & applications) should be mailed to:
Republican Women of Muscogee-Harris County
ATTN: SCHOLARSHIP CHAIR
scholarship@RWM-HC.com
APPLICATION
REPUBLICAN WOMEN OF MUSCOGEE-HARRIS COUNTY SCHOLARSHIP
Name_________________________________________________________________________
First Name______________________________________________________ Middle Initial____
Social Security Number_____________________ Date of Birth__________________________
Address_______________________________________________________________________
City_________________________________________ State_________ Zip Code____________
Phone Numbers: Home_____________________________ Cell__________________________
Currently attending: __________________________________________________________
List all schools you have attended starting with all high school. If you went to more than one start with the one you are currently attending or graduated from.
Applicants must provide original transcripts.
HIGH SCHOOL |
Name and Address of School: ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ |
Diploma?________
Date of Graduation: ___________________
Dates of Attendance: ___________________ ___________________ | Grade Average: (GPA) ____________
Grades Attended ______________ ______________ |
HIGH SCHOOL |
Name and Address of School: ________________________________________________ ________________________________________________ ________________________________________________ |
Dates of Attendance:
___________________ ___________________ | Grade Average: (GPA) ____________
Grades Attended ______________ ______________ |
HIGH SCHOOL |
Name and Address of School: ________________________________________________ ________________________________________________ ________________________________________________ |
Dates of Attendance:
___________________ ___________________ | Grade Average: (GPA) ____________
Grades Attended ______________ ______________ |
COLLEGE |
Name and Address of School: ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ |
|
Degree Desired: _________________ _________________ _________________
Dates of Acceptance: _________________ _________________ _________________ |
Expected Date of Graduation: __________
|
COLLEGE |
Name and Address of School: ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ |
|
Degree Desired: _________________ _________________ _________________
Dates of Aceptance: _________________ _________________ _________________ |
Expected Date of Graduation: __________
|
Please list any awards, special recognitions, scholarships or other honors you have received in school.
_______________________________________________________________________________
_______________________________________________________________________________
Please list any memberships in civic clubs or other extracurricular activities in which you are or have been active in high school college.
_______________________________________________________________________________
______________________________________________________________________________
Please list all employment you have held. (If this is not enough space, use extra sheets).
Employer Name & Address: ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ | Dates of Employment: From: __________________ To: ____________________ Supervisor: ________________________ | Description of Duties: _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ |
Employer Name & Address: ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ | Dates of Employment: From: __________________ To: ____________________ Supervisor: ________________________ | Description of Duties: _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ |
Employer Name & Address: ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ | Dates of Employment: From: __________________ To: ____________________ Supervisor: ________________________ | Description of Duties: _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ |
Please list any professional, civic, church, social, or recreational organizations you currently belong to outside of high school or college:
_______________________________________________________________________________
______________________________________________________________________________
Please list any volunteer services/organizations you belong to & dates: (use extra sheets if necessary.)
_______________________________________________________________________________
______________________________________________________________________________
Volunteer Organization: Duties: | Date(s): |
Volunteer Organization:
Duties: | Date(s): |
Volunteer Organization:
Duties: | Date(s): |
What college, school, or university do you expect to enter?
PROOF OF ACCEPTANCE MUST BE PROVIDED WITH THIS APPLICATION
When do you expect to graduate? __________________________
What degree will you have? ____________________________
Please use separate sheet to respond:
A. Discuss your short and long-term goals for your career.
B. Discuss how receiving this scholarship will assist you in achieving those goals.
C. Any other information you wish to provide
The above statements are true, to the best of my knowledge. I understand that any scholarship awarded may be revoked if any statement is found to be false. I understand that if I am awarded a scholarship it will be for a period of one academic year and that I will be required to sign a contract. I understand that any scholarship awarded and the amount awarded is subject to the availability of funds.
____________________________________ ___________________________________
Date Signature of Applicant
Signature Parent/Legal Guardian