2016 Scholarship Application
This single scholarship application will be used to evaluate applicants for approximately 13
distinct scholarships. Scholarships have been endowed through contributions and bequests from
individual alumni, graduating classes, and former Lakewood City Schools’ staff members. Each
endowed scholarship has unique requirements, which are used by the Foundation’s scholarship
committee to evaluate applications. The award decisions are made by a volunteer committee.
While the Foundation wishes it could award scholarships to every qualifying graduate, our
resources are limited. Decisions of the scholarship committee are final.
Scholarship awards vary in amount. Scholarship recipients are expected to attend the
Celebration of Excellence on May 11, 2016, where they will be recognized. Disbursement of
scholarship checks requires proof of college/university registration and thank you letters to
interviewers and donors. Instructions for receiving scholarship checks will be provided upon
notification of scholarship award.
To be eligible for a scholarship, a student must:
a. be a graduating Lakewood High School senior;
b. intend to pursue post-high school education either at a four-year college or university or a
community college; and,
c. demonstrate a 3.0 cumulative grade point average by the end of first semester senior year.
NOTE: Students with a 2.5 GPA or better with significant work experience or extraordinary
financial hardship may apply.
Applicants will be evaluated on:
a. academic achievement;
b. leadership potential;
c. school and community involvement;
d. financial need;
e. letters of recommendation;
f. personal interview.
A scholarship committee will interview qualifying students. This is a 10-minute interview and
will be held during the school day on Tuesday, April 5, 2016. All interviews will be scheduled
by the Foundation office and will be held at Lakewood High School.
Application Process:
Please read these instructions carefully. Failure to follow them could disqualify you from
1. Submit the application VIA EMAIL ONLY! Deadline: Wednesday, March 16, 2016.
Download the Word document “2016 Scholarship Application.”
In Word, fill in the answers beginning on the line below each question or prompt.
Save As: your ‘last name_first name’
Send this document as an email attachment to: [email protected]
2. Submit two letters of reference to the Foundation mailbox, located in the LHS Main Office, no
later than 9 a.m. on Friday, March 18, 2016. One letter must be from an LHS teacher from
whom you have taken a class. (You may use a copy of one you have on file in guidance.) One
letter must be from another adult—neighbor, family friend, employer, club advisor—who knows
you well but is not related to you or a teacher you had for class.
1) Do NOT attach any additional information (resumes, lists of awards, your
essay, etc.). All of the information must be contained with the 2016
Scholarship Application Form. Any attachments, other than your
reference letters, will be discarded.
2) Do NOT change fonts, font sizes, font attributes (like italic, bold, etc.),
3) Applications MUST be submitted VIA EMAIL.
Personal Information
Last Name, First Name:
Street Address:
Telephone Number:
Birth date (Month/Day/Year):
Parent/Legal Guardian Names:
Financial Information
EFC# (Expected Family Contribution) from FAFSA:
Parent Occupations/Places of Employment:
Sibling Name/Age/School attending:
Other dependents/relationship:
Family’s total income (Check one.)
 under $25,000
 $25,000-49,999
 $50,000-74,999
 $75,000-99,999
 $100,000-149,999
 $150,000 and above
Q. How do you plan to finance your education?
Q. Is your family experiencing any extenuating circumstances, which create an extraordinary
financial hardship?
Educational Plans
Q. Intended field of study:
Q. Schools to which I have applied:
Q. Schools to which I have been accepted:
Q. First choice school:
Q. Scholarships and grants (including amount) you have been awarded:
Q. Describe your high school attendance record, explaining any prolonged absences or absences
from school or athletics due to disciplinary action:
Extracurricular Activities
Q. Describe any special recognition you have received for academic excellence:
Q. List extracurricular activities (both school and in the community), years of participation, and
offices or positions held:
Q. List documented volunteer hours (school or community):
Q. Describe your responsibilities at home:
Q. List employment experience (employer, location, term of employment, positions held):
In fewer than 500 words, describe your Lakewood High School experience. You might describe
a particular classroom or extracurricular experience or discuss a staff member who had a
particular influence on your experience.

Lakewood Public Schools Alumni Foundation

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