Lakes Region Tourism Association of New Hampshire
Scholarship Fund (2018)
Student Application Form
2018 Scholarship up to $1,000
ELIGIBILITY: the student may complete this application before notification of college acceptance however only those students accepted at an institution of higher learning majoring and/or studying a tourism or hospitality related field would be eligible for the scholarship. One must be a New Hampshire resident to be eligible to receive this scholarship. One can be awarded this scholarship for a maximum of two years.
The following criteria are used to evaluate scholarship applicants: personal data, recommendations, scholastic aptitude, scholastic performance, essay and financial need.
1. NAME: ______
FirstMiddleLast
PHONE: ______
2. HOME ADDRESS: ______
StreetCityStateZIP
INTRODUCTION: It is important to complete each item on the application form as accurately as possible. Please provide a complete picture of yourself and your background to help the committee make a fair evaluation of your application.
3. Date New Hampshire residence was established: ______
4. Father’s Occupation: ______
Employer: ______City/Town ______
Mother’s Occupation: ______
Employer: ______City/Town ______
Guardian’s Occupation: ______
Employer: ______City/Town ______
5. Brothers and/or Sisters living at home or at college: (circle as applicable)
Name: ______Age: __ Part/Full time Employment/School___
Name: ______Age: __ Part/Full time Employment/School___
Name: ______Age: __ Part/Full time Employment/School___
Name: ______Age: __ Part/Full time Employment/School___
Name: ______Age: __ Part/Full time Employment/School___
Name: ______Age: __ Part/Full time Employment/School___
6. Application must be accompanied by high school transcript and College Board (SAT or ACT) scores and college or university grades transcript (if applicable).
A.Current high school or college level ______
7. Post secondary school or college for which applicant’s scholarship is requested:
Name of school/college: ______
City/State/Zip: ______
Anticipated Major: ______
7a.What other scholarships have you been awarded and in what amounts?
Please list the name of scholarship, who provided the scholarship and the scholarship amount:
Name of ScholarshipScholarship ProviderAmountYear
8. Describe your interests and or hobbies: ______
9. List participation in school, community organizations and activities over the past four years: Do not attach a Resume.
Organization/Activity# MonthsStatus in organization/activity
FRESHMAN YEAR
______
______
______
______
______
______
Organization/Activity# MonthsStatus in organization/activity
SOPHMORE YEAR
______
______
______
______
______
______
Organization/Activity# MonthsStatus in organization/activity
JUNIOR YEAR
______
______
______
______
______
______
Organization/Activity# MonthsStatus in organization/activity
SENIOR YEAR
______
______
______
______
______
______
10. Describe your work experiences. Indicate periods of employment in each job and list amounts earned on each job over the past four years:
______
EmployerJob Description# Weeks WorkedAverage # hours/week
______
EmployerJob Description# Weeks WorkedAverage # hours/week
______
EmployerJob Description# Weeks WorkedAverage # hours/week
______
EmployerJob Description# Weeks WorkedAverage # hours/week
______
EmployerJob Description# Weeks WorkedAverage # hours/week
______
EmployerJob Description# Weeks WorkedAverage # hours/week
11. What did you learn from your work experiences?
12. Submit three short essays of 250 to 500 words each describing:
A.Have you experienced a moment of epiphany, as if your eyes were opened to something you were previously blind to? Describe this moment and the impact that this revelation has had on you.
B.Why are you pursuing a degree and or training in the tourism/hospitality industry?
C.Explain or describe a career opportunity in tourism/hospitality in the State of New Hampshire.
13. State any other personal circumstances you feel warrant the attention of the selection committee:
14. Is there any other information that you believe might be helpful to the selection committee? You may include any awards or recognitions.
15. How did you first learn the availability of the Ron Meade “On the Track to Tourism” Scholarship?
16. The Lakes Region Tourism Association provides information to the media about scholarship recipients to help in promoting the Scholarship Auction and upcoming scholarship opportunities. Given what you have provided for personal information in this application, please write four or five sentences about yourself that the Association can use to inform the public about you.
17. Two letters of recommendation must be enclosed with your application to include:
1. First recommendation – Teacher
2.Second recommendation – Guidance Counselor, Principal, Employer or Clergy. Please note, letters must be written within the current academic year.
18. Complete the Financial Information Worksheet. See last two pages of this application.
19. Signature: ______Date: ______
Applications must be received by 3:00PM at the Lakes Region Tourism Association on March 30th, 2018
Address:
Lakes Region Tourism Association
PO Box 737
Tilton, NH03276
IMPORTANT!!!!! Please remember to attach your transcripts, SAT and/or ACT scores and references. If you are presently in college, send a copy of all your transcript and SAT scores.
Lakes Region Tourism Association Scholarship Fund
Scholarship Application 2018
FINANCIAL INFORMATION WORKSHEET
1.Complete the following information related to the college/university for which you plan to attend.
Tuition:$______
Room & Board: $ ______
Books: $ ______
Other fees: $ ______
Total Costs:$ ______
2.Indicate sources of financial assistance for the upcoming school year.
Other scholarship secured:$ ______
Student loans: $ ______
Grants:$ ______
Parent expected contribution:$ ______
Employer (student/parent):$ ______
Other relatives’ contribution: $ ______
Other (please state below*):$ ______
Total Assistance:$ ______
(*Other Sources):
Lakes Region Tourism Association
Scholarship Application 2018
FINANCIAL INFORMATION WORKSHEET (CONTINUED)
3.Student 2017 Income + Assets (MUST BE COMPLETED)
A. Indicate 2017 US Tax Return adjusted gross income from IRS form 1040 line 33, or 1040A line 19, or 1040EZ line 4: $ ______
B. Indicate expected summer/school year income for 2018/2019
Summer 2018 (3 months)$ ______
School year 2018/19 (10 months)$ ______
C. Indicate student cash, savings, CD’s,
and checking accounts:$ ______
D. Indicate value of any student’s trust:$ ______
E. Indicate value of any student owned
Stocks or Bonds:$ ______
F. Indicate value of any 529 College
Funding plans:$ ______
4.Parents combined 2018expected total income from all sources: (select one)
___ $0 - $24999__ $75000 - $99999__ $150000 + up
___ $25000 - $49999__ $100000 - $124999
___ $50000 - $74999__ $125000 - $149999
End of application