THE GREATER EAST ST. LOUIS COMMUNITY FUND

2012 – 2013 SCHOLARSHIP APPLICATION

Merit Scholar Dr. Garrett Fellowship

High School Seniors College Seniors

APPLICATION DEADLINE – April 16, 2012

NOTE: All Applicants must be residents of East St. Louis or Brooklyn

HOW TO APPLY
  1. Submit completed original application to the Greater East St. Louis Community Fund. It must be typed or printed legible in black ink. Request additional applications if needed. Answer all questions completely. If a question does not apply to you write N/A (not applicable). Leave no questions unanswered.
  2. Submit two (2) Letters of Recommendations. Recommendation letters are required. At least one recommendation must be from a teacher or counselor at your school. Reference letter format is attached.
  3. A copy of your Letter of Acceptance from college you plan on attending. Must be submitted withapplication.
  4. Personal Essay must be enclosed with your application. The essay must be no more than 250 words. Questions are noted on page 4 of the application.
  5. A photocopy of your Student Aid Report (SAR)from your University/College must be sent to the Greater East St. Louis Community Fund office. Your SAR must cover the same academic year as the application for Award.
  6. You must submit a copy of your“2012-2013 Federal Student AidReport” (FAFSA). Applications are accepted as of January 1, 2012 until funds are depleted. All Scholarship Applicants are encouraged to submit their FAFSA immediately. Visit their website at: for deadlines and instructions.
  7. Dependent Students must include parent financial information. If you will not be 24 years of age by Dec. 31st, 2012, but wish to apply as an independent, you MUST verify that you fit one of the following criteria:
  • An orphan or ward of the state
  • A parent with legal dependents
  • A married student
  1. Official Transcript - All applicants must arrange for an official academic transcript be sent directly from your high school guidance office to the Greater East St. Louis Community Fund office. The transcript must show 2011-2012 fall semester grades.
  2. Copy of Utility Bill– to verify residency in East St. Louis or Brooklyn. This must be included with your application.

Documents must be submitted to:

Greater East St. Louis Community Fund

P.O. Box 547

East St. Louis, Illinois 62202

Phone: (618) 271-2200

or electronically at

GESTLCF SCHOLARSHIP APPLICATION

Date:

APPLICANT INFORMATION

  1. Last Name: First Name: Middle:
  1. Permanent Address: City: State: Zip:
  1. Home Phone: Cell Phone: Sex: M F Age: DOB:
  1. U.S. Citizen: Yes or No
  1. Personal E-Mail:
  1. Employer: Job Title: Phone:

Parental Information

  1. Father: Job Title: Employer:
  1. Mother: Job Title: Employer:
  1. Legal Guardian: Job Title: Employer:

Describe any special circumstances in your home or family that affect your educational

goals. This may include physical conditions, disability, or family instability. Use

additional page.

  1. Living arrangement during coming academic year:

Parents Own Home Dorm Apartment Relatives

  1. College you plan to attend in fall 2012. If undecided, list your top two choices to which you have applied. Note: You will have to submit a copy of your acceptance letter before final scholarship consideration is given.

12. Name of School City & State Accepted

Yes or No Unknown
Yes or No Unknown

APPLICANT’S EDUCATIONAL INFORMATION

  1. Student Classification in the Fall 2012: (check one)

Freshman Sophomore Junior Senior

1st year Graduate 2nd year Graduate

  1. Total number of hours enrolled for 1st Semester:

1.# of Hours:

  1. Major or course of study?
  1. Degree you are pursing: Associate Bachelors Masters PhD
  1. I am an applicant for financial aid at the college I plan to attend

YES or NO? If NO, attach a note and explaining why not.

Current and anticipated financial aid resources: Source and Amounts

RESOURCES

/ ANTICIPATED AMOUNT /

APPROVED or PENDING

1. WORK STUDY
2.VETERANS OR SOCIAL SECURITY
3. SEOG
4. ILLINOIS MONETARY
5. AWARD PROGRAM
6. PELL GRANT
7. SCHOLARSHIP GRANTS
8. STAFFORD LOAN (GSL)
9. PERKINS LOAN (NDSL)
10. OTHER (describe source)
TOTAL
/ $ / $
  1. Where did you learn about this scholarship?
  1. List two local persons who are not members of your household who will know your address after you

leave school and are authorized to disclose it to us and give us their e-mail address.

1.Name: Address: City State Zip Phone

Email:

2.Name: Address: City State Zip Phone

Email:

Personal Essay

Personal Essay must be enclosed with your application. The essay must cover each of the following topics:

  1. Describe your professional and personal goals.
  1. Describe circumstances or people that have influenced you or had an effect on your achievement, and/or unusual hardships you have had to overcome or will overcome to achieve your goals.
  1. Describe volunteer involvement in community service work you have done. Concentrate on those most important to you, and would you be willing to provide community service in East St. Louis and/or Brooklyn during the coming years and if so where?
  1. Submit two personal letters of reference must be submitted for your application to be complete. Use the attached reference letter form. These letters must also be submitted by April 16, 2012.
  1. Submit a copy of a current utility bill to verify residency.
  1. REQUIRED AUTHORIZATIONS I authorize The Greater EastSt. Louis Community Fund and its agents to examine, verify and discuss my academic and/or financial records and other information which applies to me. I also understand that an unsigned or incomplete application will make me ineligible for consideration for an award.

Student’s Signature: ______Date: ______

  1. I certify to TheGreater East St. Louis Community Fund that all information here is true and complete to the best of my knowledge and that I understand that the committee makes the decision regarding my participation in this program, in reliance upon the truth and correctness of the information I provide.

Student’s Signature______Date: ______

DEADLINE FOR ALL APPLICATION IS April 16, 2012

SEND ALL INFORMATION TO:

THE GREATER EAST ST. LOUIS COMMUNITY FUND

P. O. Box 547

EAST ST. LOUIS, IL 62202

For questions call (618) 271-2200

Or

E-mail: