EmailMe Form - GCC HS Senior Scholarship 2024

PRIVACY ACT STATEMENT
Under authority of U.S. Title 10, Section 3012, the enclosed personal information will be maintained by the Scholarship Committee for administrative use and released only to the individuals needed to evaluate the application. The disclosure of the information is voluntary; however, failure to disclose all or part of the requested information may hinder evaluation of the application. The application will remain in the possession of the Scholarship Committee Chairperson for one year and will then be destroyed.

Statement of Understanding
I certify that the information in this application is true and correct to the best of my knowledge. I understand that I will be disqualified if I include false information in this application. I agree to abide by the conditions of the Scholarship Committee and in no way shall question their selection of the winners. I understand that the GCC Scholarship Committee reserves the right to contact individuals listed on this application.

I certify that the essay is my original work and I have signed and completed the acknowledgement statement listing any advice or assistance I have received. *

e-Signature of Applicant (Sponsor/Guardian if under 18 years old) and Date

*

e-Signature of Sponsor and Date

• Selection process is anonymous and packet identification will be by applicant’s Identification Code
• The selection panel will judge applications with all other identifying information removed.
• Make certain each separate document submitted has the applicant’s Identification Code in the upper right hand corner.
• Make a copy of this application for your records

Your Identification Code is the last letter of your first name, the last letter of your last name and the last four numbers of your social security number. *

Applicant's Identification Code

Name *

First MI Last

Email *

Phone *

APO Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Photocopy of applicant I.D. card (specified in “Eligibility”). Please copy both sides - .jpg or pdf file *

Sponsor's Name *

First MI Last

Sponsor's Organization *

Sponsor's Email *

Sponsor's Duty Phone *

List the colleges, universities, or vocational schools to which you have applied. Note if you have been accepted. *

What degree program do you plan to complete? What are your career plans? *

Education - Begin with the most recent


High School Attended
GPA/Scale
Dates Attended (mo/yr-mo/yr)

Cumulative Grade Point Average based on the first seven semesters of high school work (GPA/Scale) *

Activites

List all activities in which you participated while in grades 9 through 12. Begin with most the recent.

Scholastic (Honor Society, Math Team, etc.) *

Include Activity, Grade Level(s) and any Awards, Honors, or Offices Held for each. If none specify N/A.

Extracurricular (Athletics, Band, Newspaper, Student Gov., Yearbook, Drama, Clubs, etc.) *

Include Activity, Grade Level(s) and any Awards, Honors, or Offices Held for each. If none specify N/A.

Community or Volunteer (Church, Scouting, Clubs, etc.) *

Include Activity, Grade Level(s) and any Awards, Honors, or Offices Held for each. For community service, include # of hours. If none specify N/A.

List past work experience (include self-employment such as childcare, pet sitting, etc.) *

Include Job, Employer/Agency, Dates of Employment and Hours/Week. If none specify N/A.

List any other awards or recognition not listed above.

List any hobbies or interests not listed above.

Explain any circumstances that may have prevented you from participating in activities or sports during high school.

Are there any extraordinary circumstances you would like the committee to know about that have affected your transcripts and/or application? (Academic or extracurricular)

ACKNOWLEDGEMENT STATEMENT
In order to evaluate applications fairly and to preserve the integrity of the preparation process, the scholarship committee requests that every applicant complete an acknowledgement statement. Each applicant is expected to complete the packet and write and proofread the essay themselves and the result should be the applicant’s own work. However, the committee understands that an applicant might ask a teacher or parent to provide a second proofing of the essay or review the packet to be sure that it is complete. Respectfully, the committee requires that each applicant acknowledge and provide details of any assistance he or she might have received by completing the acknowledgement statement below.

I pledge that I have prepared the scholarship application packet myself and that the essay and the forms are my own work. *

e-Signature of Applicant (Sponsor/Guardian if under 18 years old) and Date

In completing my work, I have used the following resources or accepted the following types of assistance (for example, activities list screened by my parents): *

Please complete the following items offline:

Official High School transcript(s) including fall semester 2022 grades. - Electronic copies can be sent to GCCScholashipChair@gmail.com. Mail to: Scholarship Application Attn: GCC Scholarship Chair, CMR 409, Box 615, APO, AE, 09053.

One (1) recommendation letter completed by someone other than a family member or another student – pdf or .doc file sent directly from recommender to GCCScholashipChair@gmail.com.

Name and email address for recommender *

Essay - "Travel is fatal to prejudice, bigotry, and narrow-mindedness"—Mark Twain. Elaborate on this quote given your family’s assignment overseas. What lessons did you learn about your attitudes regarding travel/other cultures? How have new experiences challenged your prejudices? What have you learned about yourself and your place in the world as a result of your travels? What attitudes will you carry that were influenced by trips taken, or not taken, while you were a student here? *

Keep in mind the following:

1. The essay should be:
• a .pdf file
• 12 point, double-spaced, with one inch margins
• 300-500 words
• include a word count at the end

2. Please include your Identification Code, not your name, in the upper right hand corner of each page.

3. The essay will be evaluated on style and content, and must be grammatically correct.

4. Points will be deducted from essays that exceed the word limits.

5. Include any assistance you receive on your Acknowledgement Statement.