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North Side High School Alumni Association

475 E. State Blvd.

Fort Wayne, IN 46805

(260)

Scholarship Application 2016

(Due March 16, 2016)

General Information:The North Side Alumni Association makes available college scholarships to graduating seniors of North Side High School. The scholarships are:

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General Alumni Scholarship ($1000)

Distinguished Alumni Scholarship ($1000)

Dr. Raymond Beights Memorial Scholarship ($1000)

David & Janice Bleeke Scholarship ($1000)

Dixie Durr Memorial Scholarship ($1000)

Tom Garman Memorial Scholarship ($500)

Gabriel Shaheen Ivy Tech 1 Technical Cert. Scholarship

Richard and Roberta Snyder Scholarship ($1000)

Yant Family Scholarship ($1000)

Zwick-Lee Memorial Scholarship $1000)

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  1. Only one (1) application form needs to be submitted by students from the class of 2015.
  2. With the following exceptions, the one application will be considered as applying for all the above scholarships.
  3. The exceptions would be
  4. the Zwick-Lee Memorial which is specified for a female student who has been involved in athletics
  5. the Dixie Durr Memorial Scholarship which is specified for a student who has excelled in any area of the performing arts
  6. theDr. Raymond Beights Memorial Scholarship which is specified for a student pursuing a degree in music education/performance at Indiana University (any campus), Butler University, or Ball State
  7. the Gabriel Shaheen Ivy Tech Technical Scholarship which is specified for a student pursuing a Technical Certificate.
  8. No student will be awarded more than one (1) scholarship.

Directions: The application will consist of four pages plus a copy of the student’s official school transcript. Incomplete applications will not be considered.

Page One:A cover sheet

Page Two:General Information concerning the student

Page Three:A listing of high school and community activities as well as awards and honors earned during high school —Please note which year(s) participation occurred.

Page Four:An attached one-page student essay: In your own words, please state your educational and/or personal goals and describe the process that led to their development. Please TYPE your essay.

North Side High School Alumni Association

475 E. State Blvd.

Fort Wayne, IN 46805

(260)

Scholarship Application 2016

(Due March 16, 2016)

Your Name: ______

(Please Print neatly)LastFirst M.I.

Gender:_____Female(check all that apply)

_____I have participated in some form of athletics (includes cheerleading) at North Side

_____I have taken 4 years of foreign language at North Side (Does not have to be same language)

_____I intend to study foreign language in college

_____I have participated in some form of the performing arts at North Side

_____Male (check all that apply)

_____I have taken 4 years of foreign language at North Side

_____I intend to study foreign languages in college

_____I have participated in some form of the performing arts at North Side

NAME:______

Last FirstMiddle

ADDRESS:______

Number & StreetCity & StateZip

TELEPHONE: (______) ______-______E-Mail: ______

DATE OF BIRTH: ______COMMENCEMENT DATE: ______

MonthDay Year

PARENT/GUARDIAN NAME:______

PARENT/GUARDIAN ADDRESS:______

(If Different from Above)

______

SCHOOL YOU PLAN TO ATTEND

& IT’S ADDRESS______

______

______

ACCEPTANCE STATUS AT ABOVE SCHOOL:______ACCEPTED ______PENDING

FINANCIAL CONSIDERATIONS:

Number of Family Members in the Home:______

Number of Family Members in college (Other than Applicant)

full time for the 2016-17 school year:______

Estimated First Year College Expenses for this student:______

STUDENT SIGNATURE:______

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For Guidance/Alumni Office Use Only: Date Submitted: ______(Staff Initials: ______)

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ACTIVITIES - SERVICE - HONORS/AWARDS

Please include the grade-level years (9,10,11,12) in which participation took place

APPLICANT NAME: ______

PART I - HIGH SCHOOL ACTIVITIES AND SERVICE TO THE SCHOOL

HIGH SCHOOL ACTIVITIESSERVICE TO THE SCHOOL

______

______

______

______

______

PART II - COMMUNITY ACTIVITIES AND COMMUNITY SERVICE

COMMUNITY ACTIVITIESCOMMUNITY SERVICE

______

______

______

______

______

PART III - AWARDS, HONORS AND OFFICES HELD

IN THE HIGH SCHOOLIN THE COMMUNITY

______

______

______

______

______

Please bring your completed application to the North Side Guidance Office.

Application must be submitted by March 16, 2016.