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CENTRAL MS

OLE MISS REBEL CLUB

January 27, 2015

Dear Guidance Counselor,

Each spring the Central MS Ole Miss Rebel Club (“CMOMRC”) awards scholarships to deserving area students. These scholarships may be used for freshmen year tuition and expenses at The University of Mississippi. Last year we awarded sixteen $1,000.00 scholarships.

We are seeking nominations for scholarship recipients for the 2015-2016 academic year at Ole Miss. To be eligible, a student must be on track to graduate high school in 2015 with a “B” average and must have scored between 21 and 28 (inclusive) on the ACT. Past scholarship recipients have demonstrated leadership qualities in school, religious, and/or community organizations.

The public announcement of the scholarship winners will be made at our annual Scholarship Luncheon later this Spring. Recipients will be notified in advance and areEXPECTED to attend this event with their parents or guardian(s).

Please give the attached instructions and application to any eligible high school seniors. Student’s applications MUST be postmarked BY FRIDAY, MARCH 27, 2015 and should be sent to the following address:

CENTRAL MS OLE MISS REBEL CLUB

SCHOLARSHIP COMMITTEE

POST OFFICE BOX 13294

JACKSON, MS 39236-3294

If you have any questions or need additional information, please feel free to call me at 601-927-8544 or email me at .

Sincerely,

Bob Box

President

Central MS Ole Miss Rebel Club

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CENTRAL MS

OLE MISS REBEL CLUB SCHOLARSHIP

SCHOLARSHIP OFFERED AND POSTMARK DEADLINES

The scholarship committee will review all of the candidates and will award $1,000.00 scholarship to eligible selected students. The scholarships will be paid to the University of Mississippi, with $500.00 credited to the fall semester of 2015 and $500.00 credited to the spring semester of 2016. To be included in the selection process, your application MUST be postmarked no later than FRIDAY, MARCH 27, 2015.

ELIGIBILITY

Students must be attending a qualifying educational institution under Section 501(c) (3) of the Internal Revenue Code of 1986, as amended. The educational institution must be located within the eight counties of the CMOMRC serves (Copiah, Hinds, Leake, Madison, Rankin, Scott, Simpson, and Yazoo). Students who board at institutions outside these eight counties but maintain a home address within the counties are also eligible. Students must be on track to graduate high school in 2015 with a “B” average and an ACT score between 21 and 28 (inclusive). Past scholarship recipients have demonstrated leadership qualities in school, religious, and/or community organizations.

CRITERIA

Scholarships are awarded to eligible students based solely upon merit and without regard to gender, race, color, or creed. All applications become the property of CMOMRC and will NOT be returned.

HOW TO BE CONSIDERED

Complete the application form in FULL and send to:

CENTRAL MS OLE MISS REBEL CLUB

SCHOLARSHIP COMMITTEE

POST OFFICE BOX 13294

JACKSON, MS 39236-3294

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CENTRAL MS OLE MISS REBEL CLUB (CMOMRC)

2015-2016 SCHOLARSHIP APPLICATION

READ AND COMPLETE THIS APPLICATION CAREFULLY AND NEATLY

PRINT ONLY USING BLUE OR BLACK INK

ONLY COMPLETED APPLICATIONS WILL BE CONSIDERED

IF YOU NEED MORE SPACE TO GIVE ANY MORE INFORMATION, PLEASE ATTACH SEPARATE PAGES

PERSONAL DATA

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CENTRAL MS OLE MISS REBEL CLUB (CMOMRC)

2015-2016 SCHOLARSHIP APPLICATION

READ AND COMPLETE THIS APPLICATION CAREFULLY AND NEATLY

PRINT ONLY USING BLUE OR BLACK INK

ONLY COMPLETED APPLICATIONS WILL BE CONSIDERED

IF YOU NEED MORE SPACE TO GIVE ANY MORE INFORMATION, PLEASE ATTACH SEPARATE PAGES

NAME / PHONE
ADDRESS / EMAIL ADDRESS
CITY, STATE, ZIP / SOCIAL SECURITY NUMBER

PARENTS/GUARDIANS DATA

PARENTS/GUARDIANS NAME / PARENTS/GUARDIANS PHONE
PARENTS/GUARDIANS ADDRESS / PARENTS/GUARDIANS PHONE
PARENTS/GUARDIANSCITY, STATE, ZIP / PARENTS/GUARDIANS EMAIL ADDRESS

ACADEMIC BACKGROUND

HIGH SCHOOL / ACT SCORE
DATES ATTENDED / OVERALL GRADE POINT AVERAGE
CLASS RANK (EX: 15 OF 202 STUDENTS) / EXPECTED HIGH SCHOOL GRADUATION DATE

EXTRACURRICULAR ACTIVITIES AND HONORS

EXTRACURRICULAR ACTIVITIES AND OFFICES HELD (INCLUDE ACADEMIC, SPORTS, ETC.)
HONORS AND AWARDS RECEIVED

EMPLOYMENT INFORMATION (IF APPLICABLE)

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CENTRAL MS OLE MISS REBEL CLUB (CMOMRC)

2015-2016 SCHOLARSHIP APPLICATION

READ AND COMPLETE THIS APPLICATION CAREFULLY AND NEATLY

PRINT ONLY USING BLUE OR BLACK INK

ONLY COMPLETED APPLICATIONS WILL BE CONSIDERED

IF YOU NEED MORE SPACE TO GIVE ANY MORE INFORMATION, PLEASE ATTACH SEPARATE PAGES

CURRENT EMPLOYER (BUSINESS NAME & OWNER)
ADDRESS
CITY, STATE, ZIP
TELEPHONE
JOB TITLE AND JOB DESCRIPTION/DUTIES
WORKING HOURS PER WEEK

LIST CAREER GOALS AND OBJECTIVES

REFERENCES (MUST INCLUDE AT LEAST ONE TEACHER):

NAME / NAME
TITLE / TITLE
ADDRESS / ADDRESS
CITY, STATE, ZIP / CITY, STATE, ZIP
TELEPHONE / TELEPHONE
NAME / NAME
TITLE / TITLE
ADDRESS / ADDRESS
CITY, STATE, ZIP / CITY, STATE, ZIP
TELEPHONE / TELEPHONE

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CENTRAL MS OLE MISS REBEL CLUB (CMOMRC)

2015-2016 SCHOLARSHIP APPLICATION

READ AND COMPLETE THIS APPLICATION CAREFULLY AND NEATLY

PRINT ONLY USING BLUE OR BLACK INK

ONLY COMPLETED APPLICATIONS WILL BE CONSIDERED

IF YOU NEED MORE SPACE TO GIVE ANY MORE INFORMATION, PLEASE ATTACH SEPARATE PAGES

Please also have your guidance counselor write a letter of recommendation. The guidance counselor may mail that in separately, or you may include in in your application packet in a SEALED ENVELOPE.

Please return original application PLUS TWO (2) COPIES WITH CORRECT POSTAGE to:

CENTRAL MS OLE MISS REBEL CLUB

SCHOLARSHIP COMMITTEE

POST OFFICE BOX 13294

JACKSON, MS 39236-3294

CMOMRC scholarships are funded by the District 8 Ole Miss Alumni Club.

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