Iowa State Bank Scholarship Application

Class of 2017

IOWA STATE BANK SCHOLARSHIP APPLICATION

SCHOLARSHIP EMPHASIS

This scholarship is open to all FHS Seniors with additional consideration to existing Iowa State Bank customers, GPA, future plans to return to Jefferson County after graduation and any special family circumstances. Please be sure to address these items in your application process. You must be a student of Fairfield High School to be eligible for this scholarship.

AWARD

This award of $1,000 is to be applied to the recipient’s college expenses. The check will be made jointly payable to the student and the school. This award does come with the option of deferring the cash award to the 2nd year of college with an increase in the scholarship amount to $1,500. If this option is elected, no funds would be awarded in the first year and a check made jointly payable to the student and the school for $1,500 would be sent in year 2 provided the student is enrolled as a full-time student. Please specify your preference for the award:

 – One Time - 1st year Award of $1,000.00

 – One Time - 2nd year Award of $1,500.00 meeting the specified criteria listed above.

Please fill out the requested information as completely and accurately as possible. Type or print legibly. Application deadline is March 23rd, 2017. Please return completed application to the guidance office.

Name in full:Date of Birth:

Student’s Home Address:Telephone:

Name of parent(s) or guardian(s):

Address of parent(s) or guardian(s):

Telephone of parent(s) or guardian(s):

Father’s Occupation:

Mother’s Occupation:

GPA: ______CLASS RANK: ______OF ______

Number of years that you have attended Fairfield High School: ______

FINANCIAL: (This information is viewed only by scholarship committee.)

Number of children dependent on your parent(s) or guardian(s)? ______

Please list their name, age and what school they will be attending in 2017-18 school year.

Also please note any financial hardships that should be considered.

FUTURE PLANS:

What college, university or technical school do you plan to attend? Please include full address.

What are your career plans?

Please write a paragraph telling why you are interested in this career and where you see yourself working in 5-6 years. (Include if this means coming back to Jefferson County or not)

Any other statement or special circumstance that you would like to explain to help the selection committee better understand your situation and why you should be considered for this award.

RECOMMENDATIONS:

Please attach 3 letters of recommendations. These letters can be from educators, pastors, community leaders, employers, etc.

The information below needs to be filled out for each letter that you attach.

(Note: You do not need to receive the signatures on this form but please make sure that the attached letter of recommendation is signed. The following is for contact purposes only.)

Attached Letter of recommendations received from:

Name: ______Phone: ______

Relationship to student: ______

Name: ______Phone: ______

Relationship to student: ______

Name: ______Phone: ______

Relationship to student: ______

Note:

This scholarship is not available for Iowa State Bank employee’s children but there is an internal ISB scholarship available for this purpose. Please contact Iowa State Bank (Attn: Sue Buch) for more information on this scholarship if you are a child of an Iowa State Bank employee.

Please review this application before turning in to make sure that it is all filled out correctly. Incomplete or inaccurate information could cause this application not to be considered.

Thank you.

Iowa State Bank and Trust Company of Fairfield, Iowa