Applicant Number ________
Notice of Scholarships
Available Under the
Butler County Area Foundation
Fund
Scholarship Program
Two $500 scholarships are available annually to graduating residents of
Butler County, with two graduates honored each year.
Each applicant must be entering his or her first semester of postsecondary education at an accredited school of higher education.
An applicant may be a current year graduate or an earlier graduate
resident of Butler County who may have delayed entrance into postsecondary education at an accredited school of higher education.
Application forms, available from the guidance counselor’s office, must
be completed in electronic format. Current year graduates are to return
their applications to the school guidance counselor by April 9, 2014. A
previous year graduate making an initial entry into post-secondary
education at an accredited school of higher education may present his
or her application to the Butler County Area Foundation Fund, 457 D
Street David City, NE 68632 by the same date. All applications must be
in the hands of the Butler County Area Foundation Fund no later than
April 9th. The Foundation Scholarship Committee will evaluate the
applications immediately thereafter, notifying the successful applicants
by the end of April 2014.
Applicant Number ________
Butler County Area Foundation Fund
Scholarship Application
Cover Sheet
Applicant’s Full Name:Click here to enter text.
Applicant’s Mailing Address:Click here to enter text.
City: State: Zip: County:Click here to enter text.
Applicant’s Phone: Click here to enter text.
The following criteria will be used by BCAFF as the basis for selecting scholarship
winners:
GPA (20 points)
Essay on Career Plans (20 points)
Applicant activities, honors, work experience (30 points)
SAT/ACT/ASSET/COMPASS scores (20 points)
Composite Application (10 points)
Eligibility Requirements:
1. Must currently reside in Butler County.
2. Open to any Butler County resident attending college the following year.
3. Have applied and been accepted to a two or four year public or private college.
Scholarship portfolio must contain:
1. Completed BCAFF scholarship application, received by the Foundation no later
than April 17, 2013.
2. Verification of transcript by your Guidance Counselor prior to forwarding to the
BCAFF scholarship committee.
3. Must be submitted electronically to your Guidance Counselor, who will forward to
the BCAFF scholarship committee.
If you agree to the below requirements, please initial each of the three statements and
sign and date the bottom of this application.
Click here to enter text.I currently reside in Butler County.
Click here to enter text. I have verified my High School Transcript with my Guidance
Counselor
Applicant’s Signature:
Date:
x_______________________________
x__________________________
Applicant Number ________
High School you currently attend: Click here to enter text.
Institution of Higher Education you plan to attend: Click here to enter text.
Proposed Occupation: Click here to enter text.
Where do you plan to work when your degree is complete?
City: Click here to enter text.
State: Click here to enter text.
Cumulative Grade Point Average, as of January 1st or later: Click here to enter text.
ACT Scores: Click here to enter text.
SAT Scores: Click here to enter text.
Compass/ASSET Scores: Click here to enter text.
Other Entrance Exam Scores: Click here to enter text.
Extracurricular Activities: Mark years involved in clubs, memberships, and
extracurricular activities during high school, and list activity, including any position held,
such as President, Team Captain, etc.). Submit additional sheet if necessary, using this
format.
Years Involved
Activity
Position Held
☐9th ☐10th ☐11th ☐
Click here to enter text.
Click here to enter text.
12th
☐9th ☐10th ☐11th ☐
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12th
☐9th ☐10th ☐11th ☐
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12th
☐9th ☐10th ☐11th ☐
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12th
☐9th ☐10th ☐11th ☐
Click here to enter text.
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12th
Volunteer Activities: List community related volunteer activities during high school.
Submit additional sheet if necessary, using this format.
Dates Involved
Activity
Most Significant
Contribution
Required by high
school to complete
Click here to enter
a date.
Click here to enter
a date.
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a date.
Click here to enter
a date.
Click here to enter
Click here to enter
text.
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text.
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text.
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text.
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text.
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text.
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text.
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text.
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☐Yes
☐No
☐Yes
☐No
☐Yes
☐No
☐Yes
☐No
☐Yes
Applicant Number ________
a date.
text.
text.
☐No
Work Experience: List employment during school and summer break. Submit additional
sheet if necessary, using this format.
Dates of Employment
Place of Employment
Job Duties, Hrs Worked per
Week
Click here to enter a
date.
Click here to enter a
date.
Click here to enter a
date.
Click here to enter text.
Click here to enter text.
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Honors and Scholarships: May or may not be academic-related. Submit additional
sheet if necessary, using this format.
Month/Year Awarded
Name of Award and
Reason for Receipt of
Sponsor
Award
Click here to enter a
date.
Click here to enter a
date.
Click here to enter a
date.
Click here to enter a
date.
Click here to enter a
date.
Click here to enter text.
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Essay: In this space only, describe your intended career path (major area of study and
area of specialization, choice of college, and the occupation you propose to pursue after
graduation). Also, share your short and long term goals and how you hope to achieve
them. The essay may also include any other information that is relevant to your career
plans, however, please only use the space given below.
Click here to enter text.