BETTY J. GOULD SCHOLARSHIP APPLICATION
Cover Page
Please Print or Type
Name______SS No. ____/___/____
First Last
Address ______Phone (Day)______
City ______State _____ Zip______Phone (Eve)______
Major Area of Study:______
List your High School and GPA______
Or List you College and GPA ______
College you are currently attending or plan to attend in the fall of the current year.
______
List your employment if you are employed to assist you in college expenses______
______
Name three people who could be contacted for letters of reference on your behalf.
#1. #2 #3
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Phone______Phone______Phone______
APPLICATION DEADLINE IS ON OR BEFORE MIDNIGHT JANUARY 15TH OF THE CURRENT YEAR
Disclaimer: Financial Aid recipients please note: awards and scholarships are considered a “resource” and must be included in a students’ financial aid budget. If you are awarded a scholarship that exceeds your financial aid award, a reduction of payment of financial aid may occur.
Payment of this $2500.00 scholarship will be made directly to the college you are attending in your name, so you will be responsible for providing the pertinent information for this transfer.
QUALIFICATIONS: To be eligible for this scholarship, you must be a Custer County Resident, you must have an overall grade point average of at least 2.0, must be accepted to a college or already enrolled and attending college and show proof of financial need.
Instructions: Complete the cover page with the documentation needed and write an Essay; and submit both to Betty J. Gould Scholarship Committee, PO Box 5063, Custer, SD 57730 on or before the January 15th deadline.
ESSAY: Write an ESSAY about why you deserve to receive a Scholarship. Indicate your objectives. You may want to include information about your educational, career, and personal goals. Demonstrate your talent by writing about any special interests or special circumstances that you may wish the selection committee to consider.
ESSAY FORMAT: Use 8 ½“ by 11” white paper, type or use a computer. Limit essay to one or two pages. Use your Name and Essay as the title. Triple-space after the title and double-space the body of your essay and use 1” margins all around
APPLICATION DEADLINE IS ON OR BEFORE MIDNIGHT JANUARY 15TH OF THE CURRENT YEAR
I UNDERSTAND THAT SUBMISSION OF THIS APPLICATION AUTHORIZED THE SCHOLARSHIP COMMITTEE TO OBTAIN MY TRANSCRIPT. I HEREBY AUTHORIZE RELEASE OF ALL THE FOREGOING SCHOLARSHIP INFORMATION AND OR MATERIALS, I ALSO GIVE PERMISSION TO RELEASE MY NAME TO THE NEWSPAPERS FOR PUBLICATION.
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Signature Date