DUE: WEDNESDAY, MARCH 21, 2018

The “Common Application” can be used for a number of the local scholarships. Please only apply for those scholarships that you are eligible for. Also, check the individual scholarships to see if there are any additional requirements or information for these scholarships. Please print off however many copies of the completed scholarship application that you are applying for and turn into the Counseling office. Do not email them.

Please click in the box to check mark the scholarships below that you would like to apply for by completing this application:

Arthur L. Fischer Memorial Patriotism Scholarship

* Additional information required

*must be son/daughter/grandson/granddaughter/brother/sister of an active duty service person or a veteran

who served in WWII, Korea, Vietnam, Afghanistan, Iraq or current conflict.

Beldenville Old Car Club Scholarship *must be pursing an auto-related field

Ellsworth American Legion Scholarship * Additional information required

Ellsworth Lions Club Scholarship * Additional information required

Ellsworth Masonic Lodge Scholarship

Ellsworth Middle School Scholarship* must have attended EMS

Mason of the Year Masonic Scholarship * Additional information required

Healing Choices Scholarship *Additional information required

Hillcrest Elementary Scholarship *Additional information required

Laura Mihleis Memorial Scholarship

Robert and Evelyn Young Scholarship * Additional information required

*must have been involved in Sr. High music program for at least one year

Schumaker Family Scholarship

*must be planning to attend 4 year college

Young Minds Change Lives Educational Scholarship *Additional info required

DUE: WEDNESDAY, MARCH 21, 2018

Common Application Form

(Click on the gray area to fill in information or use the Tab button to move from field to field.)

1. Name:

2. Address:

3. Date of Birth:

4. Names and addresses of parents / guardians:

5. Names and ages of brothers / sisters:

6. Explain any special family circumstances the scholarship committee

should know about (health, finance, etc.).

7. Identify the school you plan to attend and explain why you have chosen it:

8. Have you been officially accepted by this school?

9. Estimated cost of attending college next year:

10. Parent’s monetary contribution:

11. Have you received any other financial assistance?

12. Grade point average: /12.0 scale

13. Current class rank:

14. ACT composite score:

15. Offices held / special honors / awards:

16. Extracurricular activities in high school:

17. Activities outside of high school:

18. Hobbies:

19. Work experience:

20. Please attach a typed essay defining your educational, career, and future plans/goals. Be sure to include why you feel they are best suited for you.

**The Ellsworth Community School District does not discriminate on the basis of race, color, religion, national origin,ancestry, creed, pregnancy, marital status, parental status, sexual orientation, sex, (including transgender status, change of sex or gender identity), or physical, mental, emotional, or learning disability.