/ Donivon E. Adams Memorial Scholarship

The Donivon E. Adams Memorial Scholarship is for graduating seniors of Tyler Consolidated High School. The student must reside in Tyler County, exhibit financial need, and intend to pursue a full-time course of study at an accredited institution of higher learning without receiving significant other financial aid. Preference will be given to students who present a well-groomed, neat and attentive appearance, and who exhibits a high moral character. The student must have maintained a grade point average of at least 2.5.

PLEASE SUBMIT YOUR APPLICATION TO THE GUIDANCE OFFICE BY MARCH 1, 2017

STUDENT INFORMATION

Name: ______

Permanent Address: ______

Street or PO BoxCityStateZip

What county do you live in? ______U.S. Resident?  yes no

Date of Birth: ______/______/______

Telephone: Day (______) ______-______Evening (______) ______-______

Email: ______

Father’s Name: ______Occupation: ______

Mother’s Name: ______Occupation: ______

Cumulative GPA:______Composite ACT Score:______

UNIVERSITY INFORMATION

Name of college/university in which you plan to enroll or are currently enrolled:

______

Have you been accepted?  yes no

Include a copy of the letter from the school acknowledging receipt of you application or offering you enrollment

Will you be full-time (12 or more credit hours) this fall?  yes no

Anticipated major or area of study: ______

PARENT/GUARDIAN INFORMATION

Total household income for 2015:______

Number of family members in household:______

Number of children in college 2017-2018:______

Please attach a copy of your Student Aid Report

PERSONAL ESSAY

On a separate sheet of paper, please take the time to prepare a well-developed, well-written, grammatically correct personal essay. This is your opportunity for the Selection Committee to get to know you as an individual. While GPA, ACT/SAT Scores, financial need, etc. are important selection criteria, a good essay often sets one student apart from others who are equally qualified. The essay is to be limited to one page in length.

You may want to write about an interest you have, a challenge you have overcome, or something that you are passionate about. The objective is to give you a chance to tell us about another dimension of you not previously revealed. There is no “correct” way to develop and prepare this essay. In writing about something that matters to you, you will convey a sense of yourself that will provide invaluable information during the evaluation process.

The essay must be typewritten and included with the complete application packet. Spelling and grammar do matter! If you are concerned about your writing skills, we suggest that you have a teacher or counselor proofread your essay for accuracy.

LETTER OF RECOMMENDATION

Signed and sealed letter must accompany this application.

Name: ______

Relationship: ______

When selecting someone to complete your recommendation, select someone who will be thorough in the review of your character. Select someone who knows you (and your family) well and will be able to give a candid and unbiased evaluation. Your recommendation must be completed by someone other than your parents, immediate family or school counselors. In the past, ministers, coaches, employers, supervisors, neighbors, teachers, or a friend of the family has written recommendations.

The evaluator should also provide a brief statement as to why he or she thinks you are most deserving of the scholarship.

Letter of Recommendation Form

Application Deadline: March 1, 2017

To Evaluator: The above named applicant is applying for a scholarship with the Community Foundation for the Ohio Valley, Inc. Your evaluation is needed as part of the application process. The student has authorized you to release any information you feel would be helpful in reviewing his/her application. Your cooperation in providing this information is important to the selection of award recipients. To insure confidentiality, please return this form to the student in a sealed envelope with your signature across the seal. In the space provided below, please make a statement describing the applicant’s character, school, and community leadership abilities, potential to succeed, and evidence of the student’s strengths and weaknesses, not to exceed one page in length. If you are using your letterhead, be sure to include this form in addition to your recommendation.

I am writing this evaluation on the behalf of ______

Evaluator’s Name: ______

Telephone Number: (______) ______-______

Relationship to applicant: ______

How long have you known the applicant? ______

An evaluation received with a broken seal will be rejected. Please be sure to seal and sign the envelope and return to applicant in order that it may be included along with the application packet. Remember – parents, immediate family members and school counselors are not eligible to write the evaluation.

CERTIFICATION

I certify that the information on this application is true and correct and that the essay is the product of my own efforts. If I am awarded this scholarship and my plans for attendance should change, I will immediately notify the Community Foundation for the Ohio Valley, Inc. (1310 Market Street, Wheeling, WV 26003; 304-242-3144) so that another applicant can be selected.

______

Student SignatureDate

______

Parent/Guardian SignatureDate