Alley, Williams, Carmen & King Scholarship

in Civil Engineering and Architecture

Alley, Williams, Carmen & King, Inc. established the Alley, Williams, Carmen & King Scholarship in Civil Engineering and Architecture in 1991 to stimulate academic achievement and to promote the professions of Civil Engineering and Architecture by providing financial assistance. The scholarship award will be $1,000 for the first year and $500 for each of the following consecutive three years that the recipient remains in good standing in the designated curriculum, subject to review and approval of the Selection Committee.

Graduating seniors in the Alamance-Burlington School system, at the NC School of Science and Mathematics, or at the NC School of the Arts whose primary residence is in Alamance County and who have been accepted in to a Civil Engineering or Architecture program of four or more years at an accredited college or university are eligible.

Consideration will be given to academic record, extracurricular activities in school and in the community, and financial need. Preference will be given to students accepted for admission to universities in the state of North Carolina.

IMPORTANT

TO COMPLETE THIS APPLICATION, YOU MUST

1. Send with this Application Form a 1-2 paragraph typed statement telling why you should be considered for this scholarship, your qualifications and your reasons for wanting a college civil engineering or architectural education.

2. Return this completed form, along with a recent photo to your guidance counselor who will attach a copy of your high school transcript and send the packet to Alley, Williams, Carmen, and King, Inc.

3. Have two individuals complete and return to Alley, Williams, Carmen, and King, Inc. the Recommendation Forms for the scholarship. One of these individuals should be a current teacher or school personnel and one should be an employer or non-relative residing in Alamance County. Please remind your referees to send these forms by the scholarship deadline, May 12, 2017.

COMPLETED APPLICATIONS MUST BE SUBMITTED

(POST-MARKED OR HAND DELIVERED) NO LATER THAN

MAY 12, 2017

SEND COMPLETED APPLICATIONS to the Attention of Ken Stafford

Alley, Williams, Carmen, and King, Inc.

P.O. Box 1179

Burlington, NC 27216

Or HAND DELIVER TO: 740 Chapel Hill Road, Burlington, NC 27216


APPLICATION FORM

Alley, Williams, Carmen & King Scholarship

in Civil Engineering and Architecture

Alamance Foundation

Name of Applicant ______________________________________________________

Last First Middle

Address _______________________________________________________________

City __________________________________ State ______ Zip __________

Home Phone ________________________ e-mail: ___________________________

Applicant’s Social Security Number _______________________________

High School from which you plan to graduate _________________________________

***********

Parent/Guardian ________________________________________________________

Information Last First Middle

Address _______________________________________________________________

City __________________________________ State ______ Zip __________

Relationship to Applicant ________________________________________

Parents’ Marital Status ___Married ___Single ___Separated ___Divorced ___Widowed

***********

College/University you plan to attend ________________________________________

Have you been accepted at the college/university? ¨ Yes ¨ No

Intended Major/Primary Field of Study _______________________________________

Where will applicant live? ___On Campus ___With parents ___Independently

Application - Page 1


Current and Past School Activities and Honors: _______________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Community Activities and Honors: __________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

FINANCIAL INFORMATION

Annual College Expenses Estimated Annual Resources

Tuition/Fees ______________ Family contributions

Toward school expenses ___________

Room/Board ______________

Applicant’s savings

Books/Supplies ______________ or earnings for school ___________

Personal Expenses ______________ Financial Aid

Grants ___________

Other ______________ Scholarships ___________

Loans ___________

Total _____________ Work/Study ___________

Other (specify) ___________

Other income for

School expenses

(specify) ___________

Total estimated

Annual resources ___________

Name, address and telephone number of your Financial Aid Officer at the university you plan to attend (if known):

______________________________________________________________________

______________________________________________________________________

Application - Page 2

Applicant Employment Information: Please list your employment history, including dates, starting with most recent job.

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Applicant Statement: The information provided in my application is, to the best of my knowledge, complete and accurate. I understand that false statements in my application will disqualify me from scholarship assistance. I give permission for any college or school to release any information necessary to process my application for The Alley, Carmen & King Scholarship in Civil Engineering and Architecture.

Applicant’s Signature ____________________________________ Date ___________

Parent/Guardian’s Signature ____________________________________ Date ___________

***********

A copy of the high school academic transcript must accompany the application. In addition, the school should attach an explanation of its grading system. Data requested below should be completed by the high school guidance counselor.

Weighted GPA: _________ Scholastic Rank in Class: _____ of _______

SAT Scores (Highest scores obtained in multiple testing):

Verbal: _______ Writing: __________

Math: ________ Date Taken: _____________ Total: __________

____________________________________ ________________________

Guidance Counselor (Printed Name) Telephone Number

____________________________________ __________________

Signature of Guidance Counselor Date

Application – Page 3


RECOMMENDATION FORM

The Alley, Williams, Carmen & King Scholarship

in Civil Engineering and Architecture

The student below is applying for The Alley, Williams, Carmen & King Scholarship

in Civil Engineering and Architecture for undergraduate students demonstrating merit, character, participation in extracurricular activities, and financial need. Your recommendation is needed as part of the application process. Please complete this form and return it to the attention of Ken Stafford, Alley Williams Carmen and King, Inc., PO Box 1179, Burlington, NC 27216 by May 12, 2017 (or hand deliver to 740 Chapel Hill Road, Burlington, NC)

To be completed by applicant:

Name of scholarship applicant _____________________________________________

School applicant will attend next fall _________________________________________

Major/primary field of study ________________________________________________

To be completed by reference:

How long have you known the applicant? ___________________________________

In what capacity have you known the applicant?

_____ Student ______ Employee _____ Other (specify) ________________________

Please rate the applicant in the following categories on a scale of 1 to 5 with 5 being the highest ranking and 1 being the lowest. You may also indicate “U” for unknown.

_____ Scholastic achievement _____ Extracurricular and community involvement

_____ Character _____ Potential for success at the college level

_____ Potential to achieve in chosen field

Recommendation – Page 1

Scholarship Recommendation:

Print Name

Signature

Title

Daytime Phone

Date

Recommendation – Page 2