**This application is for a one-year $2,000 scholarship to a 4-year college / university**

 

 

STUDENT INFORMATION SHEET

 

To ensure anonymity of students, this sheet will be detached from the other pages during the selection process.

 

Therefore, it is important that your school identification number and/or the last four digits of your Social Security Number be on each page of this application.

    

 

DO NOT WRITE YOUR NAME OR HAVE YOUR NAME INCLUDED ON ANY

OTHER PAGES OF THIS SCHOLARSHIP APPLICATION

 

Name:
Address:
Father’s name:
Father’s address:
Mother’s name:
Mother’s address:
		Student signature
		Date

 

 

High school:
Father’s occupation:
Father’s employer:
Mother’s occupation:
Mother’s employer:
Name of college you plan to attend:
Have you been accepted by this college?						o  Yes          o  No
If “No,” date you expect to be notified:
Field of study you plan to pursue:
Class rank			In a class of				ACT score

 

In the space below, describe how important scholarships are for you to attend college and how you plan to meet all college financial obligations:

 

In the space below, describe your family, including the ages and grades of all siblings:

 

 

PLEASE ATTACH THE FOLLOWING DOCUMENTS TO YOUR APPLICATION

 

1.  Resume Describing:

A.  School Experience (clubs, programs, athletics, etc.)

B.  Out-of-School Activities (church, lessons, scouts, etc.)

C.  Volunteer Activities

D.  Work Experience (with or without pay)

E.  Recognitions and Awards

F.  Hobbies and Special Interests

           

1. Two letters of recommendation from adults (teachers, employers, pastors, volunteer supervisors, club sponsors, coaches, etc., but not relatives), who can attest to your worthiness to receive this scholarship.  Be sure to give these individuals plenty of time to write their letters for you, and ask them to tell us what sets you apart from your peers.  Remember to ask them not to use your name anywhere in their letters.

 

1. A copy of your student transcript.

 

1. A 300-word-maximum essay describing yourself, how you came to this point in your life, your future goals, and how you will meet them.  We want to learn more about you than your resume tells.  Do not narrate your resume.  Be sure your student identification number and/or the last four digits of your Social Security Number are on each page of your essay.

 

 

ADDITIONAL INFORMATION

 

• Your student identification number and/or the last four digits of your Social Security Number must be on each sheet of this application in order for your application to be considered complete.
• This scholarship will be awarded to recipients that will be attending a 4-year college leading to a Bachelor’s Degree.
• Children of Lockport Woman’s Club members, who are qualified, will be considered impartially, along with other qualified candidates.
• For questions or clarifications, contact Paula Waxweiler, Lockport Woman’s Club member, at 815-838-1114.
• The completed packet must be postmarked by March 13, 2009, and sent to:

 

Lockport Woman’s Club

P.O. Box 256

Lockport, IL  60441