The Seminole Club of Volusia and Flagler Counties
Scholarship Application & Guidelines 2014
The Seminole Club of Volusia and Flagler Counties (hereafter called “the club”) intends to
award a total of four scholarships in individual amounts of $500 each for a total of $3000 in
2014.
Three scholarships will be awarded to students from Volusia County and two must be awarded
to a student from Flagler County. The fourth scholarship can be awarded to a student from
either county based on financial need as determined by the Office of Financial Aid.
Qualifications
1. Incoming students must have earned a high school diploma from a high school located
in Volusia and/or Flagler County.
2. The student must have been accepted and enrolled at The Florida State University
(FSU) for the Fall semester, 2014.
3. The student may apply early but must be enrolled at FSU and have made deposits to
FSU for application to be considered.
4. The Office of FSU Financial Aid will award the scholarship funds and credit the student
account based on financial need. No funds will be issued directly to the student.
5. The award may be used for tuition, housing, books, meal plans or other fees that are
directly paid to The Florida State University.
Applicants must submit the following to the club to be considered for the scholarship award by
Friday May 2, 2014
1. Scholarship application available at dbnoles.com
2. Scholarship Release of Information Form
3. Standard Release ( Photos, Videos, Quotes for promotional purposes)
Selection Criteria
1. New students from Volusia and Flagler Counties entering FSU in the Fall semester of
the award year.
2. Demonstrated financial need through the FAFSA Form
3. Merit- GPA and academic awards
Announcement of scholarship recipients will be made during the month of May, 2014
Application and Release Forms are to be emailed to NolesDB@gmail.com with the subject line
of “Scholarship” by Friday, May 2, 2014.
Seminole Club of Volusia & Flagler Counties – Scholarship Application 2014
Email your completed application with the subject line “Scholarship” by
Friday, May 2, 2014 to: NolesDB@gmail.com
If unable to transmit electronically please contact Kristie at NolesDB@gmail.com
to make submission arrangements.
Name:
High School:
FSU Email/FSUID (if known):
Permanent Address:
City, ST Zip:
Phone:
E-mail:
Permanent Residence:
State:
County:
GPA Non-Weighted:
Weighted:
SAT:
Date:
ACT:
Date:
List any Academic or Scholastic Achievements or Awards received throughout your
high school term:
Award
Awarding Organization
Date/Year Awarded
Type here…
Seminole Club of Volusia & Flagler Counties – Scholarship Application 2014
Scholarship Release of Information Form
The purpose of the Family Educational Rights and Privacy Act of 1974 and the Florida
Student Privacy Act is to protect the privacy of individual students by placing certain
restrictions on the disclosure of information contained in a student’s university records as
defined in those enactments.
I understand that in order for the University to honor a verbal or written request for
information by anyone other than the individual student and certain others authorized by
statute, both Florida Statute 1002.22(3)(d) and the federal “Buckley Amendment,” 20
U.S.C. 1232g, permit the release of such records only upon receipt of an appropriate
signed authorization from the student.
This release of information allows Florida State University to share information with the
FSU Alumni Association for the purpose of identifying students who may be eligible
for scholarship funds.
I,
FSUID
Give my FULL consent to THE FLORIDA STATE UNIVERSITY to release my student
personally identifiable records and reports and education records, including, but not
limited to, grade point average, age, financial need, enrollment and attendance
records, address and telephone to: FSU Alumni Association
I understand that it will be necessary to send a written request to revoke this
authorization.
Any information release pursuant hereto is released subject to the confidentiality
provisions of appropriate state and federal laws and regulations, which prohibit any
further disclosure of this information without the specific written consent of the person
to whom it pertains, or as otherwise permitted by such law and regulations.
Student Typewritten Signature:
Date:
Seminole Club of Volusia & Flagler Counties – Scholarship Application 2014
Standard Release
For any and all purposes, I hereby grant to the Seminole Club of Volusia and Flagler
Counties and The Florida State University Alumni Association and its employees,
agents, and assigns, the right to photograph or visually record me and use my picture,
silhouette, and other reproductions of my physical likeness (as the same may appear in
any still camera photograph and/or motion picture film or videotape recording), in and
in connection with the development of any media materials and exhibition thereof; also
in the advertising and/or publicizing of any such media. I further give the Seminole Club
of Volusia and Flagler Counties and The Florida State University Alumni Association,
and any of its employees, agents, and assigns, the right to produce and utilize in any
manner whatsoever recordings of my voice for any and all media purposes.
I hereby certify and represent that I have read the foregoing and fully understand the
meaning and effect thereof and, intending to be legally bound, I have hereunto set my
hand this
th day of
Name (typewritten)
, 2014.
Telephone Number
Seminole Club of Volusia & Flagler Counties – Scholarship Application 2014