ROXANNA BOOTH SCHOLARSHIP
PROGRAM
FOR
Current Graduates of SVHS Entering a Nursing
or Related Medical Technician Field of Study
As a longtime resident of Kenova, Roxanna Booth devoted her life to improving the lives
of her neighbors and friends in Wayne County. She was an educator for the Kenova
Independent School System and, along with her family, owned and operated several
recreational venues in the Kenova and Northern Wayne County areas. In later years, she
focused her attention on assisting young people in obtaining an education in the field of
nursing, which she considered as a most essential profession. A lifelong member of the
First Presbyterian Church of Kenova, Mrs. Booth gave the Church the charge of
maintaining her endowment and continuing to serve the needs of the residents of
Northern Wayne County.
To be eligible for this Scholarship, the applicant and his/her family must be residents of
Wayne County and/or currently reside in the Spring Valley High School District.
Graduating seniors must have attended Spring Valley High School. All Scholarships will
be awarded at the complete discretion of the First Presbyterian Church of Kenova’s
Scholarship Committee, to students on the basis of financial need, merit and personal
ambition to pursue a career in nursing or a related medical technician field of study.
Scholarships are approved for a maximum of one year. Satisfactory completion of each
year of study enables the applicant to reapply and be considered for additional funding
towards a qualified two or four year degree program. Tuition scholarships will be paid
directly to the institution of record. Help with textbook purchase may be in the form of a
reimbursement directly to the student. Roxanna Booth Scholarships are deemed
secondary to Promise or other scholarships, and therefore, may not be awarded to
applicants who receive funding from another source.
Students must secure additional educational costs by taking advantage of whatever
governmental grants, special college grants, student loans or work-study programs
available. Applying to FAFSA is a prerequisite to this application.
Scholarship recipients are required to maintain a minimum 2.5 GPA in all
coursework to remain eligible for continued funding. Copies of grades, tuition
billing and/or book receipts must be submitted to the Roxanna Booth Scholarship
contact person, as soon as they are available, so that payments can be made in a
timely manner. Typically, we do not receive direct billing from the institutions. It is
your responsibility to see that we receive the proper documentation.
The applicant should submit or cause to be submitted the following:
A cover letter expressing your background, interests, career goals and any
other information you would want to have considered
A completed Personal Information sheet along with a recent photograph
A completed Academic Report from a SVHS counselor
An official copy of your SVHS transcript
A copy of your personal and/or family’s most recent federal income tax return
(only page 1 of any current 1040 form is required)
A copy of your FAFSA eligibility report
At least two letters of reference from any of the following:
Your Pastor or other church leader
A medical area of study instructor or sponsor
A current or previous employer
Another teacher or administrator from SVHS
A personal acquaintance who knows of your ethics, motivation and goals
Once collected, the complete package should be sent or delivered to:
First Presbyterian Church of Kenova
Roxanna Booth Scholarship Program
Attn: John M. Pickens, Director
PO Box 227, Kenova, WV 25530
(1116 Chestnut Street, Kenova)
The deadline for graduating seniors for the fall semester is April 1.
Only complete applications will be considered. A personal interview will be scheduled
after your application has been reviewed by the Scholarship Committee.
Once accepted as a candidate, the majority of our communication will be through
E-mail to provide written documentation. Additional information can be obtained by
contacting John Pickens at JPRealtor1@aol.com.
Revised 11/1/13
ROXANNA BOOTH SCHOLARSHIP APPLICATION
Personal Information
It is your responsibility to update this information when necessary!
Please print legibly or type:
First_______________________________ Middle_______________________________
Last________________________________________ Date of Birth_________________
Address_________________________________________________________________
City_____________________________________ State___________ Zip____________
Phone_______________________________Cell________________________________
E-mail address___________________________________________________________
School of choice________________________________________ Accepted__________
Alternate school of choice________________________________ Accepted__________
Program_______________________________________________Accepted__________
Start date____________________ Expected graduation date_______________________
Other scholarships, grants or financial aid awarded or in progress (if any):
___________________________________________________ Status_______________
___________________________________________________ Status_______________
___________________________________________________ Status _____________
Additional information that we should take into consideration:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Signature_______________________________________ Date____________________
ROXANNA BOOTH SCHOLARSHIP PROGRAM
High School Academic Report
The Roxanna Booth Scholarship Committee of the First Presbyterian Church of
Kenova desires the following information concerning the qualification of:
___________________________________________________________, Applicant
All information will be treated as confidential. Please include a transcript.
Student ranks #_____in a graduating class of _____students with a GPA of________.
Does the student qualify for the Promise Scholarship?_____ Status_______________
Has the student applied for FAFSA? _______ Status__________________________
Has the student been granted other financial aid? ______ If yes, provide details _____
_____________________________________________________________________
_____________________________________________________________________
Scores: ACT (composite)___________ SAT (composite)______________
Student’s declared career goal ____________________________________________
Has the student applied to a Health Science program? _____ Status_______________
Name of school ______________________________________ Accepted_________
Name of program_____________________________________ Accepted_________
Remarks:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Counselor__________________ Signature_____________________ Date _______