The Ralph G. Norman Scholarship fund was established to provide assistance to young adults with learning disabilities so they may obtain success with independent living skills.
Ralph G. Norman Scholarship Application
Sponsored By:
Learning Disabilities Association of Arkansas
LDAA
Please Print or Type All blanks must be filled. If you have difficulty providing this information in typed or printed from, you may submit an audiocassette tape. If you are unable to fit a complete response to a question on the application, please write the section and heading and the completed response to the question on a separate sheet of paper. Four scholarships will be awarded, each in the amount of $2,000.00
This is available ONLY to current residents of Arkansas.
Please attach the following, each item below must be included on your application or your application will not be considered!
1. A documentation of your disability by one of the following:
A copy of your School IEP______
A copy of a Private Professional Evaluation ______
A detailed letter from your Physician about your disability ______
2. Official transcripts of all high school and /or college courses.
3. Include a two-paragraph statement of your future educational/
career goals. Also, please include a statement explaining your
financial need.
4. Two (2) letters of recommendations from an adult that can
testify to your academic abilities, personal/character, volunteer
services, and community involvement. This evaluation cannot
be from a relative.
All applications materials become the property of the Learning Disabilities Association of Arkansas. Send completed applications and attachments by April 1, 2008, (allowing 5 days for mailing) to:
Ralph G. Norman Scholarship
LDAA
7509 Cantrell Road # 103
Little Rock, Arkansas72207
Only the scholarship recipients will be notified by May 1, 2008
General Information
Name: ______Address: ______
______
City: ______State/Zip Code______
Phone: ( ) ______
Age: ______Social Security Number: ______
Are you or your family member(s) of LDAA? Yes ______No ______
Name of Member: ______
Education
Name of High School from which you graduated: ______Year graduated: ______Grade Point Average: ______
If you did not graduate from high school, did you receive a GED?
Yes _____ No _____
Information on Disability
Do you have a learning disability: Yes ______No ______What specific area is your learning disability: ______Do you receive SSI or SSD? Yes ______No ______
I certify that to the best of my knowledge and belief, all information contained in this application is true and accurate. In accepting this scholarship I (we, if recipient is a minor) give permission for theLDAA to use my name for anyscholarship publicity.
(Signature) ______(Date) ______
(Parent Signature) ______(Date)______