Centralia High School DollarsforScholars Foundation
Available Scholarships for 2013

(may be subject to change)

STUDENT NAME:

Centralia High School Dollars for Scholars Scholarships can only be used for tuition, books, or related fees.

Please check those scholarships you wish to specifically apply for:

Basic CHS Dollars for Scholars Scholarships . . . plus the following additional scholarships:

Stillwaters Estates ScholarshipDan Shea Memorial Scholarship

Frank & Polly Garland ScholarshipThorbecke’s FitLife Scholarship

Edith Gasser-Shea Memorial Scholarship CHS Counseling Center Scholarship

L & E Bottling Leadership ScholarshipCentralia McDonald’s Scholarship

George A. McCarty Memorial Scholarship Dennis Mohoric Memorial Scholarship

Parke Family Scholarship Centralia Police Officers’ Scholarship

Harry Gideon Memorial ScholarshipCentralia Rotary Scholarship

Louie Larson Memorial Scholarship Other scholarships may be available

Agnew Family Scholarship (requires essay and participation in at least one of the following activities for a period of three (3) years: student government, band, choir, strings, drama, debate, or athletics) Please see form and essay sheet below on Page 7 and 8)

Don LeBaron Athletic Scholarship (for male athletes, involved in at least one of the three major sports; additional

form required)

Alderson Scholarship (must be planning to attend Centralia College)

Darrell W. Roberts Memorial Scholarship (must have been active in FFA and pursuing a degree in agriculture)

Agriculture Scholarship (must be pursuing a degree in agriculture)

Clare Bender Memorial Scholarship (involvement in music: choir, strings, or band)

Leth Family Scholarship (must be pursuing a degree in engineering or education)

Roy Alexander Memorial Scholarship for Community Service (must be involved in a variety of community

service activities – completion of additional form required)

Centralia School District Employees’ Scholarship (parent must be employed by CSD)

Centralia Kiwanis Scholarship (must be active in Key Club)

CHS Booster Club Scholarship (must be involved in school activities)

Fords Prairie/Oakview PTO Scholarship (must have attended Fords Prairie and/or Oakview during elementary years)

ABATE Scholarship (prefer a student who is planning to attend a vocational college)

Port Blakely Scholarship (must be planning to pursue a degree in forestry, natural resources, environmental science)

Creative Arts Scholarship (requires essay describing how a work of art, photo, music, dance, theatre, or literature has impacted your life and furthered your desire to pursue the arts as a career. The essay should be no longer than one (1) page, typed, single spaced, no larger than size 12 font – (Essay sheet in on Page 6 below). Also requires two (2) letters of Personal Recommendation.)

Frances S. Oehlerich Scholarship (must be under Title One or can demonstrate other high financial need and/or is a foster child, maintained at least a3.0 GPA, and has had a job or been involved in school activities (student government, clubs or sports), or been involved in volunteer activities at school or in the community).

Centralia High School Dollars for Scholars Foundation

Scholarship Application Form

APPLICANT DATA

Name (last) (first) (middle initial)

Permanent Address(street), Centralia, WA98531

Male Female

Date of Birth (M/D/YY)Telephone Number

Father’s NameFather’s Occupation:

Father’s Address (if different from above)

Mother’s Name: Mother’s Occupation:

Mother’s Address (if different from above)

High School GPA: Rank in class:

HSPE/EOCScore: Writing Reading Mathematics Science

SCHOOL DATA

I plan to attend: (Name of Institution) in (City, State)

CHS Dollars for Scholars Foundation only awards scholarships to students attending accredited institutions as recognized by the Department of Education’s Office of Post Secondary Education. To see if the college, university, or technical school you are planning to attend qualifies, check the following website:

4 yr College/University Community College Voc-Technical

I plan to: live on campus live off campus commute

Enrolled: less than half-time half-time or more full-time

Anticipated date of graduation from post-secondary program (Month) (Year)

Major field of study: Career goal:

APPLICATION CHECKLIST

This application for student aid becomes complete and valid only when you have returned the following materials.

Application Signature required (page 3)

Current transcript of grades Submitted before application deadline

Recommendations (no more than two)Application must be typed.

Please e-mail application form to (Ms. Everley) by Friday, MARCH 16, 2013

OTHER AWARDS

Please list below the name and amount of any grants or scholarships that you have been awarded for the coming school year.

Name of Award / Amount / Granted / Financial Aid

PERSONAL DATA

Describe your work experience during the past four years. Indicate dates of employment in each job and approximate number of hours worked each week. List total amounts earned at each job.

Position / Date from (mo/yr) / Date to (mo/yr) / Hours Per Week / Amount Earned

List all school activities in which you have participated during the past four years (e.g. student government, music, sports, etc.). List all community activities in which you have participated without pay during the past four years (e.g. Red Cross, church work, volunteer work). Indicate all special awards, honors.

Activity / No. of Years of Participation / Special Awards, Honors, Offices Held

Describe your educational and career objectives and future goals (300 words or less).

Please describe how and when any unusual family or personal circumstances have affected your achievement in school, work experience, or your participation in school and community activities.

By checking this box, Icertify that, to the best of my knowledge, all statements made herein are complete and true.

Students Name: Date:

CREATIVE ARTS SCHOLARSHIP

CENTRALIA HIGH SCHOOL DOLLARS FOR SCHOLARS FOUNDATION

AGNEW FAMILY SCHOLARSHIP

DEADLINE: March 16, 2013

Thank you for your interest in the Agnew Family Scholarship. Selection will be based on the following criteria:

1)Eligible candidates shall have been enrolled full-time at Centralia High School for not less than two (2) of their last three high school years prior to submission of the application for the scholarship. Participation in Running Start or similar programs under the supervision or with the approval of Centralia High School shall not disqualify any candidate.

2)Eligible candidates must have maintained a cumulative grade point average as of the date of application of 3.0 or better.

3)Eligible candidates must have participated in at least one of the following activities for a period of three (3) years (sophomore through senior years): Student government, Band/Choir/Strings, Drama, Debate, DECA, or Athletics.

4)The CHS Dollars for Scholars application must be completed and included with the essay.

5)East application shall submit an essay with their application that complies with the following requirements:

  1. The essay shall not exceed one-thousand (1,000) words and will be on the topic “This I Know for Sure”. It is hoped that this wide-ranged topic will encourage students to examine WHO they are and HOW they think. Write from your heart.
  2. The essay shall be typed and written in English.
  3. The essay shall be 8 ½ x 11 inch plain paper, double spaced, with 10 or 12 point font.
  4. The pages of the essay shall be sequentially numbered with the author’s gender indicated adjacent to their ID number.
  5. The essay shall be submitted with the cover sheet that is signed and dated by the application. Note, however, the Selection Committee will only receive the essay showing student ID and gender. The applicant must certify that the essay has been composed by the applicant in their own words without outside assistance other than resources properly credited. Plagiarism is strictly prohibited and will result in disqualification.
  6. Grammar, spelling, and punctuation shall be considered in the evaluation process.

Student ID Number: Accumulated GPA: Male Female

Years attended at Centralia High School:

I have participated at least three (3) years (10th-12th grade) in the following qualifying activities listed above:

I certify that the following essay has been composed by me in my own words without outside assistance other than resources properly credited:

By checking this box, I certify that, to the best of my knowledge, all statements made herein are complete

and true.

Students Name: Date:

Student ID:

Male Female

THIS I KNOW FOR SURE

Page 1 of 9