LAWRENCE & LUCIMARIAN ROBERTS/HELPLINE SCHOLARSHIP

INITIAL CRITERIA AND INSTRUCTIONS

  1. Are you currently enrolled in a public or private college or university in the State of MS or for the next school year?
  1. Do you have an overall grade point average of at least 2.5 (based on a 4.0 scale)?
  1. Are you currently majoring in a behavioral health science field (i.e. social work, psychology, and counseling) or plan to major in one of these areas?
  1. Do you have family residency in Harrison, Jackson, Hancock, or Pearl River County?

If you have answered “no” to any of the above, you will not meet criteria to be considered for this scholarship. Thank you for your interest. Please feel free to complete and submit an application when criteria are met.

If you answered “yes” to all of the above, proceed with completing the application on our website at,

Application deadline is March 31st

LAWRENCE & LUCIMARIAN ROBERTS/HELPLINE SCHOLARSHIP

APPLICATION

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Name Date of Birth Student ID

______

Street Address City ZIP County

( ) ______

Home Phone FAX e-mail address (Optional)

Male _____ Female ______Race (Optional):______

______

High School NameGraduation Date City

______

Anticipated or Current College/University Choice: Anticipated or Current Major:

Volunteer Activity:

Have you ever volunteered with an established agency/organization?

YES____ NO____

If yes, please provide a brief (1 page or less) summary in your own handwriting about this experience. Include the organization name/address as well as a name and phone number of a contact person at this agency/organization and time frame of volunteer experience.

Personal Summary:

Please prepare a brief (1 page or less) summary in your own handwriting on what motivated you to pursue obtaining a college degree. Include goals and career objectives.

Letter of Reference:

Please have one letter of reference from a teacher/counselor/minister forwarded to: Lawrence & Lucimarian Roberts/Helpline Scholarship Fund c/o Gulf Coast Community Foundation, 11975 Seaway Rd, Suite B150, Gulfport, MS 39503. Attention Lisa Schonewitz.

Page Two

LLR/Helpline Scholarship Fund

Application

Transcript:

Please have an official copy of your college or high school transcript indicating your overall GPA forwarded to:

Lawrence & Lucimarian Roberts/Helpline Scholarship Fund, c/o Gulf Coast Community Foundation, 11975 Seaway Rd, Suite B150, Gulfport, MS 39503.

I certify that the above questions have been answered truthfully. I understand that if any information is determined to be falsely provided, this could result with rejection of the application from review and/or a refund request of the scholarship, if awarded.

______

Applicant Name – Please Print Date

______

Applicant Signature

Mail to:Lawrence & Lucimarian Roberts/Helpline Scholarship Fund

c/o Gulf Coast Community Foundation

11975 Seaway Rd, Suite B150

Gulfport, Mississippi 39503

All applications must be post marked no later thanMarch 31st