You can find a copy of this application on our website

2017 ANNUAL SCHOLARSHIP PROGRAM

“We believe in Good Education”

$2,000 scholarships will be awarded to students:

Graduating in 2017 from:

A. Phillip Randolph Academy

Andrew Jackson High School

First Coast High School

Jean Ribault High School

North Florida Educational Institute

Stanton College Preparatory

Safe Harbor Maritime Academy

Victory Christian Academy

William M. Raines High School

Interested parties may call Northside Business Leaders, Inc.

904.757.9600

ask for Mark Kaleel.

Completed applications should be postmarked by May 31, 2017 and mailed to:

Northside Business Leaders, Inc.

P.O. Box 28554

Jacksonville, Fl 32226-8554

Northside Business Leaders, Inc.

ANNUAL SCHOLARSHIP PROGRAM

$2,000 Scholarships for Tuition,

Books and other Educational Needs

Scholarship Criteria:

*The applicant must plan to attend an accredited College or University in the State of Florida for the 2017-2018 academic year and have submitted a completed application to attend either part-time or fulltime.

*The applicant is required to provide evidence of outstanding leadership abilities exhibited at school, church, or in the community.

*The applicant is required to have a cumulative grade point average of at least 2.5 (of a possible 4.0) at the end of the third quarter of the senior year, for grades nine through twelve.

*Although financial need is not a requirement for this scholarship, recipients will be required to complete a FAFSA prior to receiving the scholarship.

Completed applications should be postmarked by May 31, 2017 and sent to:

Northside Business Leaders, Inc.

P.O. Box 28554

Jacksonville, Fl 32226-8554

Scholarship Application

Personal Data

Last Name______First Name______Initial___

Address______

City, State, and Zip Code______

Home Phone______Cell Phone______

Email:______

Mother’s Name______

Occupation______

Father’s Name______

Occupation______

Guardian’s Name______

Occupation______

Education

School______

Grade Point Average______

Current Class Standing______

Guidance Counselor______

Counselor Telephone______

Applicants, please enclose an official transcript of your high school record for grades nine through eleven, as well as a copy of your first semester report card.

Test Scores (list any taken)

S.A.T Total ______Math ______Verbal______

A.C.T Composite______Math ______Verbal______

C.P.T English______Reading ______Math______

T.A.B.E English______Reading ______Math______

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___ Associate of Arts degree – To transfer to a four-year institution

____ Associate of Science degree program in ______

____ Certificate program in ______

In what school activities have you been involved? Please list extracurricular activities (such as sports, clubs, student government, music etc.)

What academic honors have you received? (Please list academic activities such as special honors or other recognition)

What are your hobbies? (Please list hobbies such as chess, tennis, swimming, collecting, camping, scouting etc.)

Note: You may attach additional information on a separate sheet if necessary.

What is your work experience?

Dates / Company / Duties / Salary / Supervisor / Phone / Email
Personal References

Please provide three letters of reference from (1) a teacher, (2) a member of the community unrelated to you, and (3) an additional person unrelated to you e.g. employer, counselor, minister etc.

Essay

Describe why you feel you are a worthy recipient of a scholarship from the Northside Business Leaders, Inc. (This is very important and is to be composed by the student applicant.)

Any Questions

If you have any questions about any part of this application / questionnaire, please call Mark Kaleel at 904-757-9600 or e-mail him at .

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Northside Business Leaders, Inc.

Scholarship Application Check-off list

(Please use this to help you submit a complete application.)

Answer accurately, and thoroughly all-applicable questions.

  1. SCHOOL DATA / TRANSCRIPT INFO
  1. PERSONAL DATA
  1. EDUCATION
  1. TEST SCORES
  1. ANTICIPATED MAJOR
  1. SCHOOL ACTIVITIES
  1. ACADEMIC HONORS
  1. HOBBIES
  1. WORK EXPERIENCE

10.THREE LETTERS OF REFERENCE

11. ESSAY