The Stanley Jay Kurta Charitable Trust

We wish to thank you for your interest in applying for this scholarship. Our good friend Jay Kurta is no longer with us and we wanted to keep him in our minds and in the minds of others. Jay was an exceptional person, generous, well educated and a very good friend to all that knew him. Jay was a long-standing member of The Club National in Nashua, New Hampshire.

The Stanley Jay Kurta Charitable Trust was created to honor and preserve Jay’s memory.

Eligibility Requirements

  • Applicant must be a High School graduate or have an equivalent GED.
  • Applicant must be attending or plan on attending an accredited College or University.
  • Applicant must be a child, grandchild, stepchild, step-grandchild, or adopted child of an active member of The Club National in good standing.
  • This award is for undergraduate study only.

Application Process

  • It is the applicant’s responsibility to complete this application for scholarship in its entirety and shall include all required documentation including checklist.
  • A letter from the Club National member attesting to the applicant's eligibility and member number.
  • Name of College or University with a copy of letter of admission.
  • Two (2) letters of recommendation from individuals not related to the applicant.
  • All applications must be postmarked no later than March 31, 2018.
  • All applications received are considered confidential and are reviewed only by the Members of the Board of Trustees for The Stanley Jay Kurta Charitable Trust.
  • All questions must be directed to:
Selection of Recipients
  • Selection of recipients will be based on the combination of transcripts, ACT/SAT test scores, extracurricular activities, community involvement and work experience.
  • All applicants agree to accept the decisions of the deciding board of The Stanley Jay Kurta Charitable Trust.

Award Details

  • The recipient will receive a $1,000.00 scholarship that will be paid directly to the College or University on behalf of the student.
  • This award must be applied to: tuition, books, fees, or on-campus room and board only.
  • Recipient and legal guardian agrees to allow The Stanley Jay Kurta Charitable Trust to use any photographic or electronic image taken of the award recipient for public relation and marketing purposes.

The Stanley Jay Kurta Charitable Trust Scholarship Application

Personal Information

Student Name Ms./Mr. ______

(Circle one)FirstMiddleLast

Address______

______

CityStateZip Code

Home Phone (_____)-(_____)-(______) E-Mail ______

Optional

High School ______

School NameState

Year of High School Graduation ______

College, if currently attending ______

School NameState

Year of expected College Graduation ______

Club National Member’s Name______

Club National Member’s Number______

Relationship to Applicant ______

Academic Information

The school I plan to attend is a: (please check) (__) 4 Year College/University

(__) 2 Year College

Name of school you plan to attend ______

Field of Study______

Checklist:

 Attach a copy of your high school and/or college transcripts.

 Attach a copy of your SAT/ACT scores.

 Attach a copy of the Letter of Admission from the college/university you plan to attend.

Activities

 Attach a detailed list of all school and community activities in which you have participated. Be sure to include the year of involvement, your role in each activity, and any honors achieved. Some examples would be: Athletic involvement in both school and citywide, extracurricular activities such as drama, band, social committees, etc., and community services such as Church, scouts, etc.

Personal

 Attach a written essay, 300 words or less, about “Who you are and what you want to accomplish”.

 Attach a letter from the Club National Member attesting to your eligibility.

 Attach two (2) Letters of Recommendation from individuals not related to you.

Please mail your completed application as well as all required documentation and letters, postmarked no later than March 31, 2018 to:

Mr. Carl Jean

c/o Greenerd Press & Machine Co., Inc.

41 Crown St.

Nashua NH 03060

I certify that all information provided within this scholarship application is true, complete and accurate. The Stanley Jay Kurta Charitable Trust is hereby authorized to verify any information contained in this application. I understand that any falsification or misrepresentation will result in disqualification.

Applicant’s Signature ______Date______

Member’s Signature ______Date______