9320 Lakeside Blvd, Bldg. 2, Suite 200 (281)363-8158

Montgomery County Community

The Woodlands, TX 77381 Fax: (281) 363-8191

APPLICATION

for the

Montgomery County Community Foundation

Mary Jane Hamilton Memorial Scholarship

At Lone Star College-Montgomery

The Mary Jane Hamilton Memorial Scholarship Fund at Montgomery County Community Foundation was created to benefit need-based students from Montgomery County planning to attend Lone Star College-Montgomery as full time students. This endowed scholarship fund was created in memory of May Jane Harrison Hamilton who passed away on April 2, 2003 after a courageous battle with cancer. Education was an important part of Mary’s life. Mary graduated in 1978 from Sharpstown High School in Houston, and received a BS degree in Education from The University of St. Thomas in 1982. She was an HISD elementary school teacher for 17 years. She was named Ex. Director for the PSH Foundation for the last two years of her life.

This scholarship fund was created to honor her life by her loving stepmother Patti Harrison, President of the PSH Foundation. It is Ms. Harrison’s desire to memorialize Mary by assisting other students wishing to secure a college education in Montgomery County. To qualify, applicants must enroll as full time students at Lone Star College-Montgomery.

APPLICATOIN DISTRIBUTION:Financial Aid Office of LSC-M and each participating high school Senior Counselor’s Office

DEADLINE: March 10, 2017 by 5:00 p. m. to the Financial Aid Office of Lone Star College-Montgomery, Attn: MCCF Mary Jane Hamilton Memorial Scholarship.

THE MCCF MARY JANE HAMILTON MEMORIAL SCHOLARSHIP

SCHOLARSHIP APPLICATION

Please print or type.

______

Last NameFirst NameMiddle Name Social Security Number

Date of Birth: ______

Month Day Year

Address ______

Street City State Zip

______

Home Phone Number Mobile Number

Student e-mail address: ______Parent e-mail address: ______

Probable major: ______First semester to be enrolled:______

High school attended: ______Graduation date:______

Month Day Year

Father’s occupation and employer:______

Mother’s occupation and employer:______

Family taxable income after deductions:______Number of children in family______Pre-school_____K-12_____College______

Attach the first two pages of your family’s IRS Form 1040 (private information can be blacked out) to verify taxable income.

Attach a copy of your latest high school transcript.

Attach a recommendation letter from a high school teacher or counselor.

On a separate typed sheet, list significant activities, honors, scholarships and awards received during your high school years in order of importance to you. NOTE: If you have more than ten, list the most important including information on:

Honor/ScholarshipSponsorBasis forAward Date Received

Certification:

I hereby certify that the above information is true and accurate to the best of my knowledge. Further, I authorize representatives of Montgomery County Community Foundation to release my name and/or photograph to the local news media in publications relating to the Mary Jane Hamilton Memorial Scholarship at Lone Star College-Montgomery.

______

Signature of Applicant DateSignature of Parent/Guardian (required) Date

*Appliction and attachments must be complete to be considered.