2018 WESTBROOK FOUNDATION SCHOLARSHIP APPLICATION

Personal Information
Name: / Graduation Year: / Gender:
Permanent Address:
Phone: / E-Mail:
Intended Area of Study:
College Information
List schools to which you have applied for admission, by preference, including full address with zip code.
Name of school and full address / Cost per year (tuition, room, board, fees, and books) / Does the school offer a bachelor degree in your major? Yes or No
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Other Scholarship Information
List scholarships, grants, loans and other forms of anticipated financial assistance.
Name of scholarships or grants including those you will receive from collegesat which you have been accepted / Potential Amount / Granted or Pending?

Application Checklist

Please check:

1. Completed scholarship application form (including signed affidavit by Notary Public)

2. Completed résumé (using Westbrook Foundation template)

3. 200- to 300-word essay that discusses the candidate’s interests, ambitions, concerns,

and/or specific plans for the future and addresses the candidate’s commitment to

community service

4. Up-to-500-word essay on the theme “My experience as a high school student”

5. Official transcript*

6. Official SAT or ACT score report

7 Student Aid Report (SAR)

8. Two letters of recommendation; list names below of teacher or guidance counselor:

(A)______

(B) ______

All application materials must be submitted to the Westbrook High School Guidance Office by Tuesday, April 3, 2018, at 2:30 p.m.

*Transcripts for Westbrook High School students will be automatically provided by the WHS Guidance Department. Non-WHS students should request their transcript from their respective Guidance Departments.

The affidavit below must be signed in the presence of and notarized by a Notary Public. Applicants and parents/guardians may have their signature notarized by a different notary and/or at a different time. Parent/guardian signatures are required unless the applicant is emancipated.

AFFIDAVIT (to be affirmed before a Notary Public)

Under the penalties of perjury, I do solemnly affirm that all information provided pertaining to this application, herein stated or provided separately, is true to the best of my knowledge and belief. Although confidentiality of information provided is expected of The Westbrook Foundation, I hereby authorize The Westbrook Foundation to investigate in any manner which it, in its discretion, deems necessary to determine the accuracy of the statements made in this application and my eligibility for aid. I accept the responsibility for notifying The Westbrook Foundation of any change from that stated in this application in my financial status, nature of course curriculum, change of school or career goal. I agree to make this notification immediately, in writing. I understand and agree that failure to do so may obligate me to return any scholarship granted to me by The Westbrook Foundation.

Signature of ApplicantSignature of Parent or Guardian

Required if Applicant is not Emancipated

Affirmed before me and signed in my Affirmed before me and signed in my

Presence this day ofPresence this day of

, 20 ., 20 .

(Signed) (Signed)

Notary PublicNotary Public

County StateCountyState

My Commission Expires:My Commission Expires:

Month DayYearMonthDayYear

Résumé Template for All Scholarship Applicants

Name

Mailing Address E-Mail Address Telephone #

I. Educational Goals/Career interests or Aspirations
II. Work Experience
A. Employment:
B. Volunteer/community service:
III. Honors and Awards
IV. Extracurricular Activities, Athletics, and Student Government; (include positions and offices held)
V. Other Skills and/or Experience