THE S DOLLARS FOR SCHOLARS SCHOLARSHIP TREE
Waubun-Ogema-White Earth District 435 Leaf $25, a blossom $100
218-473-6173 or Fax # 218-473-6190 Blue Bird $250, an apple $500
a branch $1000
whole tree trunk $50,000
To be considered for a Scholarship, students:
--must apply by April 15
--must be in the upper half of current graduating class academically.
--must be accepted by a post secondary school in pursuit of a degree or license
Procedures:
1. Complete all pages of this application form including the names of three references.
Sign and return the form to the Guidance office by April 15.
2. Fill in your name and the name of your references on three reference forms. Give these to each
of your references as soon as possible. The references are to return these directly to the
Guidance office.
3. Please write a 1 page summary stating your goals, your accomplishments, your plans for the future,
and any personal information you feel is important for the committee to know during
this selection process.
4. Applications must be typed or computer generated.
DOLLARS FOR SCHOLARS SCHOLARSHIP APPLICATION
Name of Applicant Click here to enter text. GPA Click here to enter text.
Post Secondary School Click here to enter text. Class Rank Click here to enter text.
I authorize Waubun High School to release grade transcripts including information on attendance, grade-point average, rank in class, and test scores to the Waubun Scholarship Foundation.
Click here to enter text.
Parent Signature or Applicant if over 18
Reference #1 Reference #2 Reference #3
Click here to enter text. Click here to enter text. Click here to enter text.
Name Name Name
Click here to enter text. Click here to enter text. Click here to enter text.
Address Address Address
Click here to enter text. Click here to enter text. Click here to enter text.
Phone # Phone # Phone #
Extra-Curricular Activities Mark (X) in appropriate years after printing out
Activities or Work outside of school:
Click here to enter text.
It is my intention to attend a post secondary school in pursuit of a degree or license.
Dollars for Scholars
Scholarship
NAME: Click here to enter text. Class Rank: Click here to enter text.
ADDRESS: Click here to enter text.
TELEPHONE: Click here to enter text.
College/School you will be attending:
Click here to enter text.
Program in which you will enroll:
Click here to enter text.
Why have you chosen this program/area of study?
Click here to enter text.
What are your long range goals?
Click here to enter text.
List activities/high school courses that have led you to choose this career.
Click here to enter text.
List your extra-curricular activities and community activities:
Click here to enter text.
List job experience/volunteer work: List name of employer and job duties.
Click here to enter text.
Tell us why you feel you should receive this award:
Click here to enter text.
Signature: Click here to enter text.
Date: Click here to enter text.
Applicant:______
Name of Reference:______
Position/Relationship to Applicant:______
To: Reference
From: Scholarship Committee
Please circle the number which best describes the applicant on each item. If you cannot make a judgement on any item, leave it blank. (Blanks will not reflect negatively on the applicant’s average score.)
Please return the form directly to the Guidance Office, Waubun High School, Attention: Dollars For Scholars, Waubun, MN - Do NOT return the form to the applicant.
Personal Traits 5- Highest 1 Lowest
Dependability 5 4 3 2 1
Honesty 5 4 3 2 1
Co-operation 5 4 3 2 1
Observance of School Rules 5 4 3 2 1
Courtesy 5 4 3 2 1
Punctuality 5 4 3 2 1
Work Habits 5 4 3 2 1
Leadership 5 4 3 2 1
Enthusiasn 5 4 3 2 1
Initiative 5 4 3 2 1
Social Responsibilit 5 4 3 2 1
Self Confidence 5 4 3 2 1
Sense of humor 5 4 3 2 1
Reaction to Criticism 5 4 3 2 1
Statement or Comment (optional)
(This information will be kept confidential and used only for Dollars for Scholars)
Applicant:______
Name of Reference:______
Position/Relationship to Applicant:______
To: Reference
From: Scholarship Committee
Please circle the number which best describes the applicant on each item. If you cannot make a judgement on any item, leave it blank. (Blanks will not reflect negatively on the applicant’s average score.)
Please return the form directly to the Guidance Office, Waubun High School, Attention: Dollars For Scholars, Waubun, MN - Do NOT return the form to the applicant.
Personal Traits 5- Highest 1- Lowest
Dependability 5 4 3 2 1
Honesty 5 4 3 2 1
Co-operation 5 4 3 2 1
Observance of School Rules 5 4 3 2 1
Courtesy 5 4 3 2 1
Punctuality 5 4 3 2 1
Work Habits 5 4 3 2 1
Leadership 5 4 3 2 1
Enthusiasn 5 4 3 2 1
Initiative 5 4 3 2 1
Social Responsibilit 5 4 3 2 1
Self Confidence 5 4 3 2 1
Sense of humor 5 4 3 2 1
Reaction to Criticism 5 4 3 2 1
Statement or Comment (optional)
(This information will be kept confidential and used only for Dollars for Scholars)
Applicant:______
Name of Reference:______
Position/Relationship to Applicant:______
To: Reference
From: Scholarship Committee
Please circle the number which best describes the applicant on each item. If you cannot make a judgement on any item, leave it blank. (Blanks will not reflect negatively on the applicant’s average score.)
Please return the form directly to the Guidance Office, Waubun High School, Attention: Dollars For Scholars, Waubun, MN - Do NOT return the form to the applicant.
Personal Traits 5- Highest 1- Lowest
Dependability 5 4 3 2 1
Honesty 5 4 3 2 1
Co-operation 5 4 3 2 1
Observance of School Rules 5 4 3 2 1
Courtesy 5 4 3 2 1
Punctuality 5 4 3 2 1
Work Habits 5 4 3 2 1
Leadership 5 4 3 2 1
Enthusiasn 5 4 3 2 1
Initiative 5 4 3 2 1
Social Responsibilit 5 4 3 2 1
Self Confidence 5 4 3 2 1
Sense of humor 5 4 3 2 1
Reaction to Criticism 5 4 3 2 1
Statement or Comment (optional)
(This information will be kept confidential and used only for Dollars for Scholars)