Pilchuck Tree Farm Scholarship – 2015
Turn in to AHS Career Center by 2:30 –May 20th, 2014.
TO THE APPLICANT:
Please complete this application so we can determine your eligibility for receiving funds set aside to help students who plan to go on to postsecondary education. Complete your sections of this application, have a teacher, advisor, counselor, job supervisor, or any person who is in position to evaluate you according to the criteria given for appraisal (page 6) complete it and return to you.
If more space is necessary to complete a question please attach it to the application with question number indicated on the attachment.
You are responsible for seeing that all supporting documents are submitted.
SCHOOL DATA:
High School Attended:______Graduation Date(month,year):______
Address:__18821 Crown Ridge Blvd. Arlington WA 98223-4015
(street)(city)(state)(zip)
360-618-6300
Telephone Number
Name of high school principal: Mr. Brian Beckley
Name of postsecondary school for which applicant’s scholarship is requested:
______
4 year College/University Community CollegeVo-TechOther
Is it accredited?
Address of College______
(street)(city)(state)(zip)
Year in postsecondary program during coming school year:Undergraduate 1 23
Student will: live on campus live off campus commute
Enrolled: less than half-time half-time or more full time
Anticipated date of graduation from postsecondary program (month, year): ______
Major field of study applicant plans to pursue: ______
OTHER AWARDS:
Please list below the name and amount of any grants or scholarships that you have been awardedfor the coming school year:
Name of awardAmountGrantedPending
______
______
______
______
______
PERSONAL DATA:
Describe your work experience during the past 4 years. Indicate dates of employment in each job and approximate number of hours worked each week.
CompanyPositionDate from (mo/yr) – to (mo/yr Hours per week
______
______
______
______
List all school activities in which you have participated during the past 4 years (i.e. music, sports, clubs, etc.) Include special awards, honors, offices held
ActivityYears ParticipatedAdvisors signature
______
______
______
______
______
______
______
List all community activities in which have participated without pay or academic credit during the past 4 years (i.e. Red Cross, church work, volunteer work) Indicate all special awards, honors.
OrganizationDutiesYear ParticipatedActivity Manager Signature_
______
______
______
______
______
______
PERSONAL DATA CONTINUED:
Make a statement of your plans as they relate to your educational and career objectives and future goals.
______
______
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.
______
APPLICATION CHECKLIST:
This application for student aid becomes complete and valid only when you have the following materials and postmarked by applications deadline.
Official Transcript or Grades Applicant Appraisal in sealed envelope
Completed application All required signatures Copy of SAT/ACT scores
APPLICANT APPRAISAL (REQUIRED)
To be completed by a high school or college counselor or advisor, an instructor, or a supervisor.
STUDENT NAME: ______
You have been asked to provide information in support of this application for financial aid. Please give immediate and serious attention to the following statement. When completed please return to applicant in a sealed envelope.
The applicant’s choice of a post secondaryeducation program is
extremely very moderately not
appropriateappropriateappropriate appropriate
The applicant’s achievements reflect his/her ability
extremely well very well moderately well not well
The applicant’s ability to set realist and attainable goal is
excellentgoodfair poor
The quality of the applicant’s commitment to school and community is
excellentgoodfair poor
The applicant is able to seek, find, and use learning resources
extremely well very well moderately well not well
The applicant demonstrates curiosity and initiative
extremely well very well moderately well not well
The applicant demonstrates good problem solving skills, follows through and completes tasks
extremely well very well moderately well not well
The applicant’s respect for self and other is
excellent good fair poor
Comments:
______
Appraiser’s Printed Name ______
______
SignatureTitleDateTelephone Number
______
Appraiser’s Business Address(street)(city)(state)(zip)
1