2017Information/Application for Founders’ Scholarship

(All submitted materials must be typed.)

The Founders’ Scholarships were established to assist people who are improving themselves through education. It was with the goal of improving themselves financially that our 10 founding members created Heritage Grove Federal Credit Union in 1964. These scholarships honor their spirit and efforts. Funding comes from credit union members and employees in the true spirit of people helping people.

Here are some Frequently Asked Questions about the scholarship:

Who is eligible?

Any Heritage Grove member, child or relative of a Heritage Grove member may apply for a Founders’ Scholarship.

What type of education is eligible?

Any accredited public or private institution of post-secondary education. Priority is given to students planning to attend public or private institutions in Oregon. The scholarship funds can be used for tuition and books.

What are the criteria for awarding the scholarship?

Applicants are evaluated based on academic performance, community involvement, their career and personal achievements and goals, and financial need.

What is the amount of the scholarship(s)?

Each Founders’ Scholarship is $1,000. The credit union awards as many as current fundraising efforts can support. For 2017 there is one (1) scholarship available.

How do I apply?

Complete the application and return it to the credit union along with the required information listed in the application.

Who should I contact if I have questions?

You can contact the credit union at (503)588-0211. A member of the scholarship committee will be able to answer your questions.

Heritage Grove Federal Credit Union

Founders’ Scholarship Application

Return to:Scholarship Committee

Heritage Grove Federal Credit Union

P.O. Box 2227

Salem, Oregon 97308

Deadline:All completed applications must be received in the branch lobby by Wednesday, May 31, 2017, 5:00 p.m.

The winner will be notified by June 16, 2017.

Please contact the credit union at (503) 588-0211 or

(877) 695-8321 with any questions.

Please type.Date: ______

Name: ______

LastFirstMiddle

Social Security Number: ______Birth date: ______

Month/Date/Year

Permanent Residence/Street Address: ______

______

CityCountyStateZip

E-Mail Address: ______Cell # ______

Are you a:U.S. citizenPermanent resident of the U.S.Neither

Date you expect to graduate from college/vocational school: ______

Month/Year

What degree will you earn? ______

High School Grade Point Average:______

College Grade Point Average (Undergraduate):______

College Grade Point Average (Graduate):______

SAT Math*: ______SAT Reading*: ______SAT Writing*: ______ACT Composite*: ______

*High school seniors: if SAT or ACT scores are unavailable, please provide PSAT scores.

Are you a graduating high school senior?Yes No

If no, when did you graduate from high school? ______

From what high school did or will you graduate? ______

______

CityCountyState

As of this coming September, what will your class standing be?

Freshman in college/vocational schoolSenior in college/vocational school

Sophomore in college/vocational schoolMaster’s program

Junior in college/vocational schoolDoctoral program

What are your anticipated or actual fields of study?

Major: ______Minor: ______

What college, university, or vocational school will you attend in the coming year?

______

SchoolCityState

Please list the address and phone number of the financial aid office of the school you will be attending:

______

______

Indicate the academic periods you plan to attend:

Fall quarter/semesterWinter quarter/semester

Spring quarter/semesterSummer quarter/semester

How long have you lived in Oregon? ______

Years Months

Are you a member of Heritage Grove Federal Credit Union?YesNo

Are you a child or relativeof aHeritage Grove Federal Credit Union member?YesNo

If yes, name of parent or relative: ______

ALL APPLICANTS MUST COMPLETE THIS SECTION

List the colleges/vocational schools or universities you previously attended:

School:______

City/State:______

When attended: ______Degree: ______

School: ______

City/State:______

When attended: ______Degree: ______

WITH THIS APPLICATION PLEASE INCLUDE:

Letter of Recommendation:

Include a letter of recommendation from a non-family member (teacher, employer, clergy, etc.).

Transcripts:

High School Seniors:Your most recent semester high school transcript, showing grade point average. Also enclose SAT or ACT score report.

College Freshman:High school and college transcripts.

All Other Students:Transcripts of college work.

Financial Information:

Enclose copies of your Student Aid Report if you filed a Free Application for Federal Student Aid (FAFSA) and your Financial Aid Award Letter from your school if you received one. If you do not have these items available, please forward them to us as soon as they are available.

Application Questions (Please type.)

  1. Why are you applying for aHeritage Grove scholarship?
  2. List any scholarships, fellowships, grants, or tuition and fee waivers, which you will receive during the coming academic year (including dollar amount):

Source$ Amount

  1. Activities
  2. List your most significant high school activities. Please number each activity (1, 2, 3, etc.).
  3. List your most significant college activities (if applicable). Please number each activity (1, 2, 3, etc.).
  4. How have you been involved in your community? Include community activities and work experience. Please number each activity (1, 2, 3, etc.).
  1. Please describe any special circumstances (financial, medical, unemployment, etc.) we should be aware of in considering your application.
  1. Describe your educational, career and personal goals. If you win this award, how will it help you attain these goals?

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CERTIFICATION

I certify that all information, which I have provided, on this form is true and complete to the best of my knowledge. If requested, I agree to give proof of the information on this application. I understand that the scholarship selection committee may review information provided on this form, my transcripts, and my need for financial assistance based on the information provided. If selected to receive a scholarship, I give permission for a publicity release including the use of my name and image in credit union publications.

______

Signature of Applicant(Area Code) Phone NumberDate

______

Signature of Parent/Legal Guardian*Date

*The parent/legal guardian consent is required if the applicant is under the age of 18.

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