APPLETON CITY HIGH SCHOOL ALUMNI SCHOLARSHIP FOUNDATION, INC.
APPLICATION PAGE 1
ASSIGNED ID (For alumni use only)
Judged by out-of-town alumni
Personal Information
NAME:
ADDRESS:
Signature:
HOME TELEPHONE:
CELL PHONE:
EMAIL:
BIRTH DATE:
Instructions for Completing Application:
1. Please fill out name, address, phone number and date of birth on this page only.
Your packet will be presented to the judges with an assigned ID, so that all
Applicants remain anonymous. Please make sure your packet is stapled together
When turned in.
2. Applicants will be judged on career interest, financial need, neatness, work and
Academic information, and activities. If you do not have room to include all your
information on the form provided, you may add up to two additional pages using
size 12 font and resume format (again without your name.) It will be important
that you keep your answers concise. (For example, you need not list every medal
you have received in Track, but rather state that you participated in Track 3 of
your 4 high school years and received numerous medals.)
3. Application should be neat and accurately completed.
Scholarship Details:
1. Applications must be completed and returned to the counselor’s office by
Tuesday, 9:00AM, March 17, 2015.
2. The scholarship is to be used for expenses related to attending any college,
university, or trade school.
3. The student needs to present to the Appleton City High School Alumni Scholarship
Foundation, Inc. treasurer evidence of enrollment in a school by August 15,
2015 or the money will be presented to an alternate.
4. Scholarship winners will be announced at the Graduation Ceremony and also, at
the Alumni Meeting, which we would like you to attend on Saturday, May 23,
2015.
APPLETON CITY HIGH SCHOOL ALUMNI SCHOLARSHIP FOUNDATION, INC.
APPLICATION PAGE 2
Education:
High School (s) attended in the last 4 years.
Year of Graduation (if graduating early or late please explain):
Grade Point Average:
ACT Composite Score:
Future Education Plans or Goals:
College/Trade School Choice/Address:
Career Interest and College Major:
Financial Needs:
Father’s Occupation:
Mother’s Occupation:
Please mark the line below that best represents your family’s 3-year average
Adjusted Gross Income. To arrive at this amount, add the Adjusted Gross Income
Of the last 3 years filings of the Federal income tax returns and divide by 3.
3 year average Household Income
0-$20,000
$20,000-30,000
$30,000-50,000
$50,000+
_________ _____________
_____________
___________
Are there other siblings attending college currently ________If yes, please explain:
Family circumstances you feel need to be noted:
Why do you feel you need financial assistance?
Have you saved towards your post secondary education? ______If yes, what have
you done?
Will it be necessary for you to work while going to school? ______If yes, do you have
arrangements made for work?
If you do not receive enough in grants or scholarships will you attend advanced
training? ________yes ________no
If you need additional money what will be the source?
____student loan _____bank loan _____parent loan _____parent gift
APPLETON CITY HIGH SCHOOL ALUMNI SCHOLARSHIP FOUNDATION, INC.
APPLICATION PAGE 3
Involvement/Activities: (Be Brief)
SCHOOL:
COMMUNITY:
HONORS/AWARDS:
Write an essay about your plans for the future indicating any expertise you have in
that field. DO NOT sign your name.
Attach 2 letters of recommendation—one from school personnel, second your
choice. Ask them to refer to you as the student or my friend, associate, employee,
etc. DO NOT use your name.
IMPORTANT—When returning the hard copy application please ask to sign &
date the signature page or envelope addressed to the Alumni Scholarship Committee.
This is a check list that insures the committee that all applicants are in the packet for
evaluation.