Student Identification Number ______
HAZELWOOD PTA COUNCIL SCHOLARSHIP APPLICATION
PURPOSE:
To provide scholarships up to one hundred (100) deserving Hazelwood School District High School graduating
seniors.
AWARD COMPONENTS:
Up to one hundred (100) $500 scholarships and individual certificates awarded up to one hundred (100)
students selected by the Hazelwood PTA Council Selection Committee. The number of scholarships awarded
to students of each Hazelwood High School (Central High, East High, and West High) is determined annually,
based on senior class enrollment as of January 1st of each year.
CRITERIA:
1. Applicant must be a graduating Hazelwood School District high school senior in the year of the award.
2. Applicant must have been enrolled at a Hazelwood High School at least 2 years.
3. Applicant must have at least 95% average attendance during the fall semester of senior year.
Exceptions may be considered upon request of Counselor.
4. Applicant must rank in the upper fourth of their graduating class as of the first day of the second
semester in the year of the award.
5. Applicant must demonstrate school and community involvement.
6. Applicant must have completed required community service by application deadline.
7. Applicant must demonstrate appropriate school conduct throughout their senior year.
8. Applicant must sign up to volunteer at or participate in the Hazelwood PTA Scholarship Run / Walk by
application deadline.
9. Scholarship funds awarded must be applied to expenses incurred for the winner’s post-secondary
education, beginning with the current calendar year.
APPLICATION PROCESS:
1. Complete typed application form. (Handwritten and / or incomplete applications will not be
processed).
2. Deadline for application is April 2, 2016. Applications received after this date will not be considered.
A copy of this application can also be found at www.hazelwoodptacouncil.com
3. The Scholarship Selection Committee will be formed annually by March 1st. The Committee shall
consist of at least 12 members; the Hazelwood PTA Council Scholarship Committee, the High School
Principals, the Guidance Department Managers, and PTA Members.
4. The decisions of the Scholarship Selection Committee shall be final. Hazelwood PTA Council
Scholarships will be awarded without reference to other scholarships, grants, or financial aid received
by the awardees.
5. The Scholarship Selection Committee determines which awardees will be designated to receive
honorary or named scholarships. Examples include the Thomas J. Lawson Scholarship, The Francis C.
Huss Scholarship, the Judith D. Huss Scholarship, and the Gibbons Family Scholarship.
6. Award recipients shall indicate acceptance of the scholarship no later than August 1st of the current
year. A parent and / or guardian of each recipient shall be required to guarantee the return of any
Hazelwood PTA Council Scholarship money received if the recipient does not attend school during the
academic year that starts in the fall of the current calendar year. Recipients may attend any
recognized post-secondary academic institution, including trade or technical schools.
[LEFT BLANK INTENTIONALLY]
Student Identification Number ______
Hazelwood PTA Council Scholarship Application
COVER PAGE
Student Name
Phone Number (
)
Address
Street, City, State, Zip Code
Current HSD High School
Central, East, or West
Please list all HSD Schools Attended (Elementary, Middle, and High School)
Note: This information is requested for recordkeeping only. This will not be considered in the application selection process.
Important:
Place only your Student Identification Number at the top of each application page.
Please do not place your name on any application page other than this Cover Page
Please do not reference your high school by name in the written responses on Page 2
Page 1
Student Identification Number ______
Hazelwood PTA Council Scholarship Application
A. Activities / Organizations:
Please list Activities / Organizations in school and outside of school. Indicate offices held and
accomplishments while in office. Include PTSA membership / activities. Please list in descending order
of significance. Limit 8 Activities and Organizations.
1.
2.
3.
4.
5.
6.
7.
8.
B. Honors / Awards:
Please list in descending order of significance. Limit 5 Honors and Awards.
1.
2.
3.
4.
5.
C. Work Experience:
Include both paid and volunteer work experience and job duties performed. Indicate length of
employment or volunteer service. Limit 3
1.
2.
3.
Page 2
Student Identification Number ______
Hazelwood PTA Council Scholarship Application
D. Where do you plan to continue your education after high school, and what subject matter or
profession do you intend to pursue, and why? (Limit your statement to 100 words or less)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
E. What are the three most significant courses you have taken in preparation for your career? Briefly
explain why these courses were most significant. (Limit your statement to 100 words or less)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
F. Where do you see yourself in your career ten years from your high school graduation? (Limit your
statement to 100 words or less)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Page 3
Student Identification Number ______
Hazelwood PTA Council Scholarship Application
G. In ten years what impact on your community do you wish to have? (Limit your statement to 100 words
or less)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________