Rolling Hills Scholarship

APPLICATION FORM

The Annie Ternoir Rolling Hills Employee and Family Scholarship

sponsored by Slovak American Charitable Association (SACA)

Providing Charitable Outreach

Scholarship Application Year______(Fall Enrollment Only)

Organizational Mission

The Slovak American Charitable Association, guided and empowered by its charter, exists to provide charitable outreach. We serve those in need as we represent the values of our heritage by loving and caring for each other, and those individuals and organizations which strive for dignity, respect and care within the community.

Our Philosophy

SACA is a not-for-profit organization that owns and operates Rolling Hills Campus in Zion, IL. Rolling Hills Manor provides skilled care and rehabilitation services for the elderly. Rolling Hills Place is a senior independent and assisted living residence. The organization supports charitable causes and serves individuals without ethnic discrimination.

Name ______

Permanent Address ______

City, State, Zip ______Telephone # ______

Email______Cellular #______

Anticipated or Declared Major ______

Undergraduate_____ Graduate_____ Degree Seeking______

College or University Attending ______

Address ______

Telephone # of Financial Aid Office ______

How did you learn of the Rolling Hills Scholarship?

Please list any other scholarships, awards or loans you have applied for or that have been approved:

Applied Approved Applied Approved

______

I hereby affirm that I am a U.S. citizen or permanent resident, and a permanent resident of Illinois or Wisconsin. I will be attending the above mentioned college or university. I also understand and meet the eligibility and application requirements and agree to the scholarship fund distribution rules if selected for a scholarship. I am submitting a 2 page essay with this application.

____ If I am awarded a Rolling Hills Scholarship, I hereby give permission for Slovak American Charitable Association to publish my name, the name of the school I will be attending, the city where I permanently reside, my academic major and the amount of the scholarship award in the Rolling Hills Campus News, which is mailed to members and supporters of Rolling Hills Campus and SACA.

Applicant’s Signature ______Date ______

This completed application form; essay, certified transcript and letters of recommendation should be mailed to the following address: No incomplete or late submissions will be considered. Deadline is to be postmarked no later than April 1st

Rolling Hills Scholarship Committee Chairperson

c/o Lucia Stefo

647 Brierwood Court

Antioch, IL 60002

847-456-3800

The Annie Ternoir Rolling Hills Employee and Family Scholarship

Sponsored by Slovak American Charitable Association (SACA)

Providing Charitable Outreach

Amount: $1,000

* Eligibility: To be considered for the Annie Ternoir Rolling Hills Employee Scholarship, applicantsmust:

Be a United States citizenor permanent resident

Be a permanent resident of Illinois or Wisconsin

Have been a current employee (at least 20 hrs. per week) of Rolling Hills Campus

for a minimum of one year oran immediate family member of an employee

Have completed a minimum of 8 credit hours of undergraduate study

Be enrolled in an accredited 2 or 4 year college or university in the

U.S. for undergraduate or graduate studyand be pursuing a health-care related degree

Have a cumulative grade point average of at least 2.5 or equivalent on a 4.0

scale for the most recent 8 hours of college credits received

Provisions: Each scholarship will be:

Awarded on a yearly basis; the same individual may reapply for a maximum of one

additional year

Based on GPA, submission of an application form, a 2-page essay (800-900 words) describing how the applicant's goals relate to the mission and philosophy of SACA as stated on page one, letters of recommendation on letterhead stationery, one of which must be from a faculty member or employer.

Based on the final decision of the scholarship committee.

*Members of the Board of Directors of Slovak American Charitable Association and their families are not eligible

The Annie Ternoir Rolling Hills Employee and Family Scholarship

For students

Sponsored by Slovak American Charitable Association (SACA)

Providing Charitable Outreach

Annie Ternoir Scholarship Application Requirements

Scholarship applications will be accepted between March 1 and April 1 to be

consideredfor the fall term of that year

Applications will be reviewed by the scholarship committee and will be awarded

by June 1

Applicants must submit a certified transcript of coursework for the most recent academic

year of studyin which at least 8 credit hours have been awarded

Upon receipt, all applications will be considered the property of SACA and will be kept

confidential

Any expenses incurred with filing this application will be borne by the applicant.

All decisions of the committee are final

Scholarship Fund Distribution Rules

The disbursement of the scholarship will proceed as follows:

One scholarship will be awarded per year to a currently enrolled college student who

have completed at least 8 credit hours of undergraduate study

The $1,000 will be prorated over the number of terms of the academic year.

The scholarship recipient will submit the tuition bill to the SACA treasurer for payment directly to the school.

Any remaining funds will be paid to the student to be used toward room and board, books, fees and transportation.

Withdrawal from school or failure to maintain a 2.5 GPAfor a minimum of 8 credit hours of study will terminate the scholarship.

For more information, contact:

Lucia Stefo (847)456-3800