MichiganSchool Counselor Association

Scholarship Form

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The Michigan School Counselor Association will grant a cash award in the amount of $1,000 to a graduating high school senior in the State of Michigan attending a post-high school educational program during the 2013-2014 academic year.

Applicants should submit an essay of no more than 500 words in length describing how a school counselor (elementary, middle/junior high school, high school) has helped him or her learn to live, learn and work. Specific examples of instances when the counselor has taught the student in a classroom/large group setting, helped with individual planning and been available for personal/social counseling must be included in the essay. In addition, the student’s assessment of the counselor’s impact on school climate must be included.

Applications must be submitted no later than March 1, 2013.

Mail applications to:

Lynda Bykerk-Rupke

2211 Lake Drive SE

Grand RapidsMI49506

Email:

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Student’s Name: ______

Home Street Address: ______

City: ______State: ______Zip Code: ______

Phone: ______Email:______

Post-HighSchool Training/Education Program Student Will Attend: ______

Student’s Intended Program of Study: ______

High School from Which Student Will Graduate: ______Graduation Date: ______

High School Street Address: ______

City: ______State: ______Zip Code: ______

High School Counselor’s Name: ______

Counselor’s Email: ______Counselor’s Work Phone: ______

Applicant’s Signature:

This signature verifies that

this is my original work.

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PLEASE ATTACH ESSAY WHEN SUBMITTING THIS FORM.

Harry and Susanne Clay Scholarship for Graduate Study in School Counseling

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A scholarship has been established by Harry and Susanne Clay in the amount of $2,000 to be awarded to an applicant pursuing course work leading to a Master’s or other advanced degree in school counseling. The scholarship is intended to be used for tuition and/or books and will be awarded annually on June 1st.

REQUIREMENTS

Applications must:

be accepted as a student in an approved preparation program for school counseling.

hold current membership (regular or student) in the Michigan School Counselor Association (MSCA).

complete a written statement of no more than 500 words describing their vision for school counseling and the contribution they expect to make to professional school counseling.

submit at least one (1) letter of recommendation from someone who can speak to the applicant’s promise as a contributor to professional school counseling.

return the application form, recommendation and statement no later than March 1, 2013 to:

Lynda Bykerk-Rupke

2211 Lake Drive SE

Grand RapidsMI49506

email:

______

Applicant’s Name: ______

Home Street Address: ______

City: ______State: ______Zip Code: ______

Phone: ______Email:______

Employer: ______

Employer Street Address: ______

City: ______State: ______Zip Code: ______

Reference Name: ______Position: ______

Reference Street Address: ______

City: ______State: ______Zip Code: ______

College/University where Applicant is Accepted: ______

Anticipated Completion of Degree: ______

Applicant’s Signature: ______

This form may be reproduced.