SOUTH CENTRAL COUNSELING ASSOCIATION SCHOLARSHIP
2012-2013 Application
***Applicants MUST be pursuing an education degree at the post-secondary level and attending a Kentucky university or college***
Applicant’s Name: ______
Address: ______
Street or P. O. Box, City, State, Zip Code
Phone number: ( ) ______Date of Birth: ______
Father’s Occupation ______Place of Employment ______
Mother’s Occupation ______Place of Employment ______
Gross Family Income ______
Number of siblings at home ______Ages ______
Number of siblings in college ______Grade Level(s) ______
Have you worked during the school year? Yes or No
Where? ______Avg. number of hours worked ______
ACT Composite ______GPA (4.0 Scale) ______
List honors or Advanced Placement courses you have taken.
List your major accomplishments, awards, honors or recognitions during high school:
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SOUTH CENTRAL COUNSELING ASSOCIATION SCHOLARSHIP
2012-2013 Application
List school and community activities during high school that you have been involved in along with any leadership roles that you have played in that organization.
List scholarships already awarded including amounts if known:
*Please note if a Governor’s Scholars or Governor’s School for the Arts participant
Please write a paragraph that explains what circumstances place you in financial need.
Please tell in 500 words or less who or what influenced your decision to go into the field of education.
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SOUTH CENTRAL COUNSELING ASSOCIATION SCHOLARSHIP
2012-2013 Application
What is the name and address of the Kentucky College or university you will attend during the 2013-2014 school year?
Name of school ______
School’s Mailing address
______
Street or P. O. Box
City State Zip
ATTACH THE FOLLOWING TO YOUR APPLICATION:
1) A copy of your letter of acceptance from the college you plan to attend
2) Scholarship award letter/form if applicable
3) An official copy of your 7-semester high school transcript with attendance
4) One letter of recommendation from school or community leader
· Note: The following areas will be viewed more critically for this scholarship: financial need, previous scholarships awarded, GPA, college entrance scores, and area of college major (should be educationally-related).
· If you need extra space for any application items, please feel free to attach a copy. Please make sure you make reference to the item you are completing on the attached sheet.
· THE COMPLETED APPLICATION IS TO BE GIVEN TO YOUR COUNSELOR. PLEASE DO NOT MAIL IT YOURSELF.
· COUNSELORS, mail them to the current SCCA Scholarship Chair, Amy Hallman, Franklin-Simpson High School, 400 South College Street, Franklin, KY 42134. Postmark deadline is March 15th.
To be completed by school counselor:
Due Date: ______
SCCA member: ______(An SCCA member must be employed in the school system in order for the high school to participate in the scholarship program. School counselor must submit the application.)