2017 Kravitz Orthodontics Scholarship for Academic Achievement

Application CoverSheet

Kravitz Orthodontics is proud to offer scholarships to graduating seniors planning to enter and attend a university, college or technical school in the fall following graduation. The PTSA Scholarship Review Committee will choose applicants on behalf of Kravitz Orthodontics based on eligibility requirements and completion of this application.

Members of the review committee shall remain anonymous. The committee will read and score all applications and essays resulting in the selection of one candidate as recipient of the Kravitz Orthodontics Scholarship for Academic Achievement. One scholarship will be awarded in the amount of $250.

The scholarship funds must be utilized for school expenses only. The PTSA will prepare scholarship checks written directly to the institution. If a recipient fails to complete his or her obligations as outlined, the unused scholarship allocations and/or forfeited funds will remain the property of Kravitz Orthodontics.

CompletedScholarshipApplicationsmust be submitted toMrs. Porto inthe Career Centerby May2,2017.

Eligibility Requirements:

  • Musthave beenaJCHSstudentfor atleast2years
  • Musthavea GPAof 3.0 orhigher
  • Student must be a member of the JCHS PTSA
  • Must be acceptedto adegree orcertificationprogramatanaccreditedjunioror communitycollege, technical institute, orfour-yearcollegeor university (to be verified by JCHS school counselor)

ApplicationsMustInclude the Following:

1.ThisCoverSheet

2.UnofficialTranscript

3.Record of Activities

4.Essay

5.TwoLettersof Recommendation(submitted separately)

StudentName:

Parent/Guardian:

Address:

Phone:

Parent/GuardianEmail:

StudentEmail:

Letters of Recommendationwererequestedfromthe following people:

1.Name Phone/Email

2.Name Phone/Email

Application Instructions

DO NOT STAPLEthe pages of yourapplication.Use apaperclip.Include the following pages:

1.CoverSheet

2.UnofficialTranscript

Overview:MinimumGPAof 3.0. Yourtranscript shouldshowacademicsuccessor academicprogressin

challengingclasses.

Detail:Anunofficial transcriptincludingsenior year gradesfrom1st, 2ndand3rdquartermust be attached.

3.Record of Activities

Overview:Showthat you hada high levelof involvement incommunityorschool activities.There should bestrongevidence of leadership, personal responsibility and initiative, withconsistentand dedicated participationinactivitiesoverthe high school years.

Detail: Include a year byyear listingof activities,limited to thehighschool time frame only-- positions held,

anyhonorsor awardsyou received, time commitment (total hours), etc. Activitiesmaybe schoolrelated, community related, paidor unpaid. Remember toinclude allvolunteer workandanycampsor academicenrichment programs attended.Youcanuse your resume, ifitincludessufficientinformation,asthisattachment.

4.Essay

Tell ussomething that you wantusto knowaboutyourself that isnot elsewherein the application.Explainhowthishascontributed to you to be the person you are today.

Detail: Essay should be no more than 500 words.

5.Youmustalso obtain TwoLettersof Recommendation

Overview:Twolettersofrecommendationfromnon-relatedadultsarerequired. One lettermust be fromamember of the JCHS community (teacher,staff,coach, etc.) The secondlettershould be fromanotheradultwho knows you wellbut doesnothave to be associatedwithJCHS.

Detail: Fillinyour nameat the top of theLetterofRecommendation Formandgive itto yourreference as

soonas possible.Remindthepersonwho iswriting theletterof recommendationthatit isdue to Mrs. Porto by

May2,2017and thatthe Letterof Recommendation Formmustaccompany the letter.

Letter of Recommendation Form for:

(Student Name)

Thank you for agreeing toserve asareference for aJohn ChampeHigh School student. The Kravitz Orthodontics Scholarship for Academic Achievementisaone-time,$250 awardgivento agraduatingsenior who hasbeenaJohn ChampeHighSchoolstudentforatleast2 years, hasa GPAof 3.0 or higher, and hasbeenacceptedto adegree orcertificationprogramatanaccreditedjunior or communitycollege, technical institute, orfour-yearcollegeor university.

Pleasecomplete thisformand submititwith a letterof recommendationthataddressesthe student’scharacter, academicability, andpersonalcommitment tocontinuingeducation.A significantfactor for the awardof thescholarshipisthe applicant’sinvolvement in communityorschool activities.Please include commentsonsuchcharacteristicsas leadership, initiative, perseverance, integrityandresponsibility, aswell asanyadditional informationor extenuatingcircumstancesthat youbelievemighthelpthecommittee make its decision.

ThedeadlineforreceiptofthisformandtheletterofrecommendationisMay2,2017.PleasesenditpriortoMay2to:

Maria Porto,Career Center Specialist

Attn:ScholarshipCommittee

John Champe High School

41535 Sacred Mountain Street

Aldie, VA 20105

Mrs. Portomay be reachedat 703-722-2687

YourName:

Signature:

Relationshipto the Student:

Phone:

Email:

Below Average / Average / Above Average / Excellent / Outstanding / One of the top few I’ve ever encountered / Unable to determine
Academic Motivation
Academic Self Discipline
Academic Promise
Leadership Potential
Character / Integrity
Maturity
Extracurricular Accomplishments
Community Contributions

Letter of Recommendation Form for:

(Student Name)

Thank you for agreeing toserve asareference for aJohn ChampeHigh School student.Kravitz Orthodontics Scholarship for Academic Achievementisaone-time,$250 awardgivento agraduatingsenior who hasbeenaJohn ChampeHighSchoolstudentforatleast2 years, hasa GPAof 3.0 or higher, and hasbeenacceptedto adegree orcertificationprogramatanaccreditedjunior or communitycollege, technical institute, orfour-yearcollegeor university.

Pleasecomplete thisformand submititwith a letterof recommendationthataddressesthe student’scharacter, academicability, andpersonalcommitment tocontinuingeducation.A significantfactor for the awardof thescholarshipisthe applicant’sinvolvement in communityorschool activities.Please include commentsonsuchcharacteristicsas leadership, initiative, perseverance, integrityandresponsibility, aswell asanyadditional informationor extenuatingcircumstancesthat youbelievemighthelpthecommittee make its decision.

ThedeadlineforreceiptofthisformandtheletterofrecommendationisMay2,2017.PleasesenditpriortoMay2to:

Maria Porto,Career Center Specialist

Attn:ScholarshipCommittee

John Champe High School

41535 Sacred Mountain Street

Aldie, VA 20105

Mrs. Portomay be reachedat 703-722-2687

YourName:

Signature:

Relationshipto the Student:

Phone:

Email:

Below Average / Average / Above Average / Excellent / Outstanding / One of the top few I’ve ever encountered / Unable to determine
Academic Motivation
Academic Self Discipline
Academic Promise
Leadership Potential
Character / Integrity
Maturity
Extracurricular Accomplishments
Community Contributions