Norbert L. Gazin Education Fund Application for Scholarship
2015
Please submit the attached application to the Guidance Office
by March 20, 2015.
* NO LATE OR INCOMPLETE APPLICATIONS WILL BE CONSIDERED. It is the student's responsibility to make sure all parts of the application are in by the deadline date.
Requirements:
1. Applicant must:
a. Be born in Lewis County OR parents resided in Lewis County at the time of birth.
b. Be a resident of Lewis County for at least five (5) years prior to application.
c. Be a graduate (or will be a graduate) of a Lewis County High School.
d. Have no felony convictions.
e. Be enrolling or enrolled in a full-time college program.
2. PRIORITY will be given to eligible applicants enrolling or enrolled in schools of:
a. Engineering b. Agriculture c. Forestry
3. a. High School Applicants who are not declaring one of the priority majors should have a minimum of an 80 G.P.A. to apply for the Gazin Scholarship.
b. High School Applicants who are declaring PRIORITY (engineering, agriculture, or forestry) major must have a minimum of a 70 G.P.A. to apply for the Gazin Scholarship.
c. Alumni may apply for the Gazin Scholarship each year however; they should have a minimum of a 2.5 cumulative G.P.A. and submit the most recent transcript (Fall 2014).
d. Graduate students may apply for the Gazin Scholarship if they qualify for the priority majors only: engineering, agriculture, or forestry and have a minimum G.P.A. of 3.0.
The Gazin Scholarship is becoming more competitive each year. A minimum G.P.A. criteria has been established to apply, however, the committee reserves the right to determine winners each year to maintain the integrity of the scholarship. Winners will be notified by July 1, 2015.
*Attach to your application:
___ Complete high school transcript (for high school students) or
Complete college transcript w/cumulative GPA (for college students)
___ Copy of your birth certificate (new applicants only)
___ Copy of college acceptance letter (for high school students)
(Current college students who are submitting college transcripts DO NOT have to attach acceptance letter.)
___ Student Paragraph
NORBERT L. GAZIN EDUCATIONAL FUND SCHOLARSHIP APPLICATION
2015
Information to be completed by STUDENT (Please Print or Type)
Student’s Name: High School
Address: ______
DOB: _ Social Security #: Telephone #:
Cumulative G.P.A. ______Date of High School Graduation______
Have you ever been convicted of a felony? Yes _____ No_____ (If yes, you are not eligible.)
Were your parents residing in Lewis County at the time of your birth? Yes _____ No ______(If no, you are not eligible.)
Have you resided in Lewis County for at least five (5) years? Yes_____ No ______(If no, you are not eligible.)
College/Training
Name of college/trade school you expect to attend
Address: ______City: ______State: ______Zip: ______
Have you been accepted? Yes _____ No _____ (if yes, attach copy of acceptance letter)
Major course of study/trade
Anticipated date of program completion______Full-Time _____(If not full time, you are not eligible.)
Alumni Only:
Have you previously received this award? Yes _____ No _____
If so, please state the date(s) of award: ______
Everything that I have stated in this application is correct to the best of my knowledge. I understand that you will retain this application whether or not it is approved.
Student’s Signature Date
WORK EXPERIENCE: (Part-time, full-time or vacation, paid or volunteer)
*You may attach an activities resume*
Employer
/Employer’s Address
/Title
/Start Date
/End Date
SCHOOL & EXTRACURRICULAR ACTIVITIES:
List all school organizations, major activities, honors and offices held.
List out-of-school organizations, memberships and offices held.
List hobbies, recreation and sport activities.
STUDENT PARAGRAPH
What is your anticipated career and why did you select it? PLEASE ATTACH A TYPED PARAGRAPH
Information to be completed PARENT (Please print or Type)
Information regarding applicant’s family:
Father, Stepfather, Guardian (circle one) Mother, Stepmother, Guardian (circle one)
Name Name
Address Address
List brothers and sisters in household, including names, ages and year in school.