2012-2013 Charles Schwab Foundation Scholarship
Staff Recommendation Form
(*Note: This form will be destroyed upon completion of judging to protect sensitive information.)
Name of Candidate ______
*Candidate’s Social Security Number ______
*Disclaimer: In the event a candidate is selected as scholarship winner, travel may be involved. Trips may include government clearance to various venues, therefore a Social Security Number isrequired.
Name of Chief Professional Officer ______
Signature of Chief Professional Officer ______
Organization ______
Club ______
Staff/Contact Person______Position______
Phone Email ______
Signature (Staff/Contact Person) ______Date ______
Staff Public RelationsContact______
Email______
The staff member should complete the following questions after the application is completed and submit it Boys & Girls Clubs of America. Pleasetype responses on separate sheet of paper using 12 point Arial font.
1. How has the candidate demonstrated involvement in and support of Boys & Girls Clubs?
2. Discuss the candidate’s participation in Money Matters: Make It CountSM.
3.Does the candidate demonstrate the ability to speak publicly in front of large groups or the media? If yes, please explain.
Yes _____ No _____
4. Do you recommend this candidate for the Charles Schwab Foundation Scholarship?
Yes _____ No _____
2012-2013 Charles Schwab Foundation Scholarships
Club Member Application Form
1.Provide the following information below:
Name Last First Middle Initial
Address
Number and StreetApt.
City StateZIP
Home Telephone ( )
Email______
2.Provide information about the high school from which you will graduate:
High School Name Graduation Year
City State
Classification: Senior______Junior______
3.Provide information on the college, university or trade school you plan to attend:
Name
City State
Major Field of Study
4.Provide the following information about your gender and ethnic group:
Gender: Male ____ Female _____
Ethnic Group (check one):
_____ African American
_____ Caucasian
_____ Hispanic
_____ Asian
_____ American Indian
_____ Multi-ethnic
_____ Other
- Provide contact information for the Club staff person recommending you:
Club Staff
LastFirstInitial
Position______
Club Address ______
Number and Street City State ZIP
Work Phone ( ) Email______
6. Provide the following information for your parent(s) or guardian(s):
Parent/Guardian Last First Initial
Address Number and Street Apt
Work Phone ( )Home Phone ( )
Type responses to these questions on separate sheet(s) of paper using 12point Arial font.
Academic Success: Club and School Involvement
1.Identify your Club and school activities. Include starting and ending dates (month/year) and a description of the activity. Please be thorough in your answers and include all necessary information.
Good Character and Citizenship: Volunteer and Paid Work Experience
2.Identify your volunteer and paid work experience. Include starting and ending dates (month/year), and a description of the activity. Please be thorough in your answers and include all necessary information.
Goals and Aspirations
3.List and discuss your short and long-term goals.
Money Matters Program Participation
4. Explain your participation in the Money Matters program. Discuss how it will help you achieve your goals and aspirations.
5. Which chapter in the Money Matters Teen Personal Finance Guide was most impactful to you? Please explain.
6. List recognition awards, achievements and accomplishments you’ve received.
7. If you were the Money Matters Ambassador and needed to recruit teens for the next session, how would you promote the program?
After Money Matters
8.What did you do differently after participating in the Money Matters program? Be specific and explain concrete changes in your attitudes and behaviors.
9. Describe how your saving or spending patterns have changed since participating in the program.
For the purpose of judging my qualifications as it relates to the Money Matters scholarship, along with my parent(s)/guardian(s), I give BGCA permission to share my complete scholarship packet (excluding my personal information such as my Social Security number), with reviewers from BGCA’s National Office and Charles Schwab Foundation. I hereby attest that all information contained in this application form and attached supporting materials are to the best of my knowledge truthful, accurate and complete. I (we) hereby consent to any and all use, including but not limited to print and online publication of photographs or information received, taken or submitted in relation to this scholarship application.
______
Applicant Signature Date
______
Parent or Guardian Signature(if under 18) Date