Missouri Beta Club Scholarship Application

MISSOURI BETA CLUB SCHOLARSHIP APPLICATION

General Rules:

1. Copy this application as many times as needed. Use copies of this form ONLY. Do not add auxiliary pages. Be sure applicants submit 2 reference pages.

2. All forms must be typed.

3. A senior BETA member in good standing who is interested in attending one of the

colleges or universities listed below is eligible to apply for the scholarship.

4. The State BETA Council Chairman will appoint a team to screen all applications

that will be presented to the State BETA Council. Three candidates (unless the

Council feels others should be considered) will be selected to be presented to the

Council for first selection interviews.

5. The Missouri BETA Council will act as the board of review to interview the

selected applicants and choose the scholarship recipient at the State Convention

on Saturday (Time and place to be announced Friday night).

6. The recipient and an adult representative from his/her club must be in attendance

at the State Convention in March.

7. A SEPARATE APPLICATION FORM MUST BE COMPLETED FOR EACH COLLEGE

OR UNIVERSITY TO WHICH THE STUDENT WISHES TO APPLY.

8. The Application must be sent certified mail. DO NOT MAIL TO THE UNIVERSITY

OR TO THE NATIONAL BETA CLUB OFFICE. All forms and information must be

sent at one time in one envelope.

Applications For: Applications For:

Missouri State Southeast Missouri State

Send to: and/or

Mr. Derek Urhahn, BETA Scholarship Three Rivers Community College

Dexter High SchoolSend to:

1101 West Grant Mr. James Watts, BETA Scholarship

Dexter High School Principal, Lesterville R-IV School

Dexter, MO 63841 PO Box 120

Lesterville MO 63654

APPLICATION FORMS MUST BE POSTMARKED BY THE DEADLINE DATE OF

JANUARY 25, 2017.

Value of Scholarships Offered:

These scholarships are provided to the Missouri Beta Club for the active senior members who meet all qualifications and are selected by the Missouri Beta Council. The following information is accurate and complete to the best of the knowledge of the members of the Missouri Beta Council. Any changes in the value of the scholarships will be at the discretion of each school that provides the scholarship.

Missouri State

One time scholarship of $1500 (nonrenewable); Can be combined with other university scholarships (except Presidential). For more information, contact Dr. Tim Hager.

Southeast Missouri State

Full tuition up to 15 hours per semester up to 30 hours per year. Room and board in specified

campus housing. Renewable for 8 semesters. Must maintain 3.5 GPA with a minimum of 30 hours cumulative per year.

Three Rivers Community College

Full tuition plus rental books and fees. Further details can be obtained by contacting Tim Hager.

NOTE: All schools that offer scholarships will also offer other scholarships of similar value.

Scholarships such as Board of Governors, Freshman Academic, and/or Freshman Achievement Scholarships cannot be duplicated with the Missouri BETA Scholarship.

Each scholarship finalist will receive a “one-time” scholarship of $500 that is good for any postsecondary institution of his/her choice upon proof of enrollment submitted to Mr. Derek Urhahn.

SEE APPLICATION BELOW:

MISSOURI SCHOLARSHIP INFORMATION

SECTION I: Information to be supplied by the applicant. Please type the information.

TO WHICH COLLEGE OR UNIVERSITY ARE YOU MAKING APPLICATION?

______

Name ______Social Security No. ______

(first) (full middle name) (last)

School Name: ______

Full name of Parent / Guardian: ______

Permanent Address Of Parent/Guardian: ______

(street, box, or route) (town) (state) (zip)

Applicant, use the remaining space to write an explanation of your future plans for your education, goals you have set for yourself, etc.

Section II:

School Activities: List activities, including year(s), in which you have participated during high school. Include clubs, teams, musical groups, etc. Note major accomplishment in each. Select no more than 10.

Year Activity and Accomplishments

9//11/14

__/__/__/______

Leadership Positions: List elected or appointed leadership positions, including year(s) held in school, community, or work activities. Only those positions in which you were directly responsible for directing or motivating others should be included. For example: elected student body, class or club officer; committee chairperson; team captain; newspaper editor; work area manager or community leaders. Select no more than 10.

Year Leadership Position Activity / Organization

9/11/14

__/__/__/______

Leadership Positions continued:

__/__/__/______

_/__/__/______

Community Activities: List community activities, including year(s), in which you have participated and note any major accomplishments Only include activities outside of school in which you participated for the betterment of your community. For example: church groups, clubs sponsored outside the school, Boy or Girl Scouts, volunteer groups, or community art endeavors. Select no more than 10.

YearCommunity Activity and Major Accomplishments

9/11/14

__/__/__/______

Work Experience, Recognition and Awards: List below any job experiences, honors, or recognition, including year(s), that you have received which support your bid to be a leader. Select no more than 10.

YearJob, Recognition or Award Group or Activity

9/11/14

__/__/__/______

Section III. Information to be supplied by the High School Principal or School Counselor.

This information should be enclosed in a separate sealed envelope and mailed with the application.

Student Name ______

(first) (full middle name) (last)

The above applicant is ranked ______based on the first seven semesters.

There are ______seniors in the class. The applicant will graduate ______.

Indicate applicant’s scores on one of the following college aptitude test (use ACT if available).

Date Tested Raw Score Percentile Rank

ACT Eng Math Read Sci.Reas ComEng Math Read Sci.Reas Com

______

SAT Verbal Math Verbal Math

______

Enclose a copy of the student’s high school transcript reflecting seven semesters.

(signed) ______

(title) ______

Name of School ______

Address ______

______

Date ______