Megan O’Shea/Durst Scholarship Application
Megan Durst was a special education teacher who loved her family, job, and life. She was a caring, kind person who was loyal to all those she taught and loved. Megan lived her life with integrity and received much joy from helping others.
Please return your application securing all pages together with a paper clip. If you have any questions about anything in this packet please email Robin Shaffer at
DO NOT WRITE ON THE BACK OF ANY PAGE OF THIS APPLICATION.
Applications are to be turned in by
Mondy, April 25, 2016
Thank You
Megan O’Shea/Durst SCHOLARSHIP NOMINATION FORM
1.This scholarship is intended for those seniors who are currently in the Special Education Program at SVH and will be attending post-secondary education. It is also open to those seniors who will be majoring in EDUCATION or more specifically SPECIAL EDUCATION.
2.Any senior that has already received a full scholarship does not qualify for this scholarship.
3.Nomination forms should be completed by the nominee, and references should be completed
by a school representative or someone with similar authority, ie. any one of the following: PRINCIPAL, ADMINISTRATOR, GUIDANCE COUNSELOR, TEACHER , CLEREGY, BUSINESSMAN etc.
4.Nominations must be received no later thanApril 25, 2016and turned into the
guidance office to Ms. Michelle Kostlich or email it to .
5.All information must be typed or printed in a clear, legible manner and attached to this
nomination form. Do NOT use the back of any paper.
6.PLEASE ATTACH TRANSCRIPT TO THIS FORM.
On the following attached pages, please answer the questions as thoroughly as possible.
NAME OF NOMINEE______
NOMINEE HOME ADDRESS______
CITY______ZIP______
HOME PHONE NUMBER______
Family’s estimated yearly income______
How will you be paying for college? Please check all that apply.
_____Grants ______Amount _____Scholarships ______Amount
_____loans ______Parental commitment ______Your responsibility
COLLEGE YOU HOPE TO ATTEND______
YEARLY COST______
INTENDED MAJOR
I attest that all facts contained in this nomination packet are true and I give permission for the facts to be used for publication.
Nominee SignatureDate
Page 1
List Academic Achievements and Participation In Extra-Curricular Activities
List ANY TIME IN YOUR LIFE WHERE YOU HAVE SHOWN COMPASSION TOWARD SOMEONE, CARED FOR SOMEONE, AND/OR HELPED SOMEONE IN TIME OF NEED
NAME:______Page 2
For those intending to major in education, PLEASE ANSWER THE FOLLOWING ESSAY QUESTION: What made you decide to be a teacher, and how will you use Megan’s qualities (listed on the first page) in your teaching as well as in life?
Name______Page 3
For those Special Education students attending college: PLEASE ANSWER THE FOLLOWING ESSAY QUESTION: What does receiving this scholarship mean to you, and what qualities of Megan’s (listed on the first page) do you see in yourself and why?
Name______Page4
REFERENCE FORM
NOMINEE’S NAME:______
REFERENCE FROM:______POSITION:______
Summarize why you believe the Nominee should be selected as the recipient of the Megan Durst Scholarship. Each area is equally weighed in evaluating the Nominee. To the extent possible, comment on the criteria characteristics in selection of this Award:
Citizenship, Community Service, Dedication, Loyalty, Character, Honesty, Academic Achievement, Leadership, Morality
I attest that all facts contained in this reference form are true and give my permission for my comments to be used for publicizing this award. Signature:______Date:______Page 5