Clara Gardner--Burch Scholarship
Application for 2015
Instructions: (1) You must complete this application form in full. (2) Read the Guidelines printed on the
back of this application and attach all required documents, recommendations, and other information.
Failure to follow instructions may result in disqualification.
Name ____________________________________________ Age as of 8/01/2015________________
Birthdate ______________________________________ Phone Number (______)_____-__________
Address ____________________________________________________________________________
Street, Route, Box
City
State
Zip-Code +4
Name of High School attended or now attending ___________________________________________
Address_____________________________________________________________________________
City
State
Zip-Code+4
(Circle One)
BOY
GIRL
Parents Names _______________________________________________________________________
Address, if different then your own ____________________________________________________
Street, Route, or Box
____________________________________________________________________________________
City
State
Zip-Code +4
Name of State in which they are members of Association and Auxiliary. ________________________
*NOTE: List of Non-Family Plan States – AK, AZ, AR, CT, HA, IL, KY, ME, MD, MA, MT, NV, NH, NM,
RI, UT, VT, WA, WY. If your parent(s) are members in these states a $10.00 application fee must accompany
this application made out to “NRLCA Auxiliary”. If you apply for other NRLCA Auxiliary scholarships a
$10.00 application fee must accompany each application. (These fees are non-refundable.) Also annual dues
of $4.00 must be paid to Auxiliary Secretary/Treasurer Elizabeth Sullivan, 13029 Hwy 265, Jefferson SC
29718-6804 with check made out to “NRLCA Auxiliary”.
DO NOT MAIL MULTIPLE COPIES OF THE SAME SCHOLARSHIP.
APPLICATION MUST BE POSTMARKED NO LATER THAN MARCH 1, 2015
Mail to:
Helen Schuster, Vice President
Auxiliary of NRLCA
183 News St
Jacksonville, FL 32211-7830
This form may be duplicated or copied, but must be in the EXACT format. NO EXCEPTIONS!
Clara Gardner-Burch Scholarship
Sponsored by The
Auxiliary of the NRLCA
Two $500.00 Scholarships will be awarded annually. One scholarship each will be awarded to a boy and
a girl, who are pursuing a post-secondary education. If there is no qualified applicant in a category, none
will be awarded. The scholarship will be awarded on the basis of need and the desire to pursue higher
education and a career.
The applicant must meet the following guidelines and complete the application in full.
Failure to do so may result in disqualification.
1.
Applicant must be a High School Junior or Senior with a “B” grade average, verified by
transcript and is not married.
2.
Applicant must submit a completed application form and recommendations from two (2) teachers,
or one (1) teacher and (1) guidance counselor.
3.
The applicant must also submit a brief essay explaining their career goals and why higher
education is desired. The essay must also give information that will support the need for financial
help.
4.
If there is not an eligible Senior, then a Junior pursuing a college preparatory curriculum will be
considered. If a Junior is awarded the scholarship, he or she will not be eligible to apply the
following year. Winners must send proof of enrollment to the National Auxiliary SecretaryTreasurer to receive scholarship funds.
5.
Applicants must be children of a Rural Letter Carrier, regular, retired, or substitute, who is a
member in good standing of the NRLCA and whose spouse is a member of the NRLCA Auxiliary.
6.
The National Auxiliary Board will be the caretakers of this Scholarship.
7.
A check will be made out to the individual recipient of each category. A scholarship check will not
be issued to the winner until proof of full time enrollment in the chosen school is received by the
National Auxiliary Secretary/Treasurer, Elizabeth Sullivan, 13029 Hwy 265, Jefferson SC 29718.
A committee consisting of the Auxiliary President, Vice-president, Secretary-Treasurer shall decide the
Scholarship awards. The Vice-President shall be the chairman of the committee. The decision of the
committee is final.
The recipient may receive only one (1) of the scholarships sponsored by the Auxiliary of the National
Letter Carriers’ Association during his/her award year.
APPLICATION MUST BE POSTMARKED NO LATER THAN MARCH 1, 2015
Caretaker for 2015:
Helen Schuster, Vice President
Auxiliary of NRLCA
183 News St
Jacksonville FL 32211-7830