Logan County Retired Teachers Association

Scholarship Award Application

This scholarship is for $1000.00 and will be awarded by the scholarship committee of the Logan County Retired Teachers Association. It is to be awarded to a senior attending a high School at Indian Lake, Riverside, Bellefontaine, Benjamin Logan or West Liberty Salem Schools. The student must be a resident of Logan County and must have plans to attend a college or university, majoring in Education. The scholarship money is to be used for tuition, room and board.

This award is for the first year of school and the basis for this selection is the total number of points in the following categories:

Leadership (15)Scholarship(30)

Character (20)Financial Aid(35)

*In case of a tie attendance will be considered.

Please fill in all the information requested as fully and accurately as you can. Please type or print the information requested. (Printed information is preferred.) Mail the completed application directly to The Midwest Regional Educational Service Center, 121 South Opera St., Bellefontaine, Ohio 43311. Due by March 15, 2016.

YOUR NAME ______

YOUR ADDRESS ______

YOUR PARENTS (GUARDIANS)______

I am presently a senior at ______High School.

To the best of my knowledge, all of the information contained in this application is accurate.

______

Date Applicant’s Signature

______

Parent/Guardian’s Signature

  1. I have been accepted at, and plan to attend ______

where I plan to major in education. The yearly tuition is ______.

  1. I have already received scholarships or grants totaling $______or loans totaling $______.
  1. May parents can give about $______to help defray expenses.
  1. I can contribute from my savings, summer work, etc. about $______to help defray expenses.
  1. My father works at ______as a ______.
  1. My mother works at ______as a ______.
  1. The total number of dependents claimed on my parents federal income tax for this year ______.
  1. Please attach a transcript of your high school courses and grades, ACT/SAT scores, attendance record, class rank, and cumulative point average.
  1. Attach the two completed Scholarship Recommendation Forms.
  1. Attach a page of your in-school and out-of-school activities.
  1. In the space below or on a separate page write a paragraph explaining your reason or motivation for entering the education profession.

SCHOLARSHIP RECOMMENDATION FORM

Please be accurate and honest as you can when completing this recommendation for ______, a student at ______.

  1. I have known this student for ____ year(s), and I have known this student as a (teacher, Boy Scout leader, minister, etc.) ______.

Comments:

  1. Comment on this student’s character, as you know it.
  1. Comment on this student’s leadership abilities.
  1. Do you feel this student is worthy of a scholarship? ______

Explain:

Signature______

SCHOLARSHIP RECOMMENDATION FORM

Please be accurate and honest as you can when completing this recommendation for ______, a student at ______.

  1. I have known this student for ____ year(s), and I have known this student as a (teacher, Boy Scout leader, minister, etc.) ______.

Comments:

  1. Comment on this student’s character, as you know it.
  1. Comment on this student’s leadership abilities.
  1. Do you feel this student is worthy of a scholarship? ______

Explain:

Signature______

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9/2014

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