Pathway Partners Mentoring Program Scholarship The Pathway Partners Mentoring Program will be offering one $500 scholarship sponsored by Marshfield Sunrise Rotary Club. Applicants must be program students in grades 10-12 at Marshfield High School who plan to attend an accredited university, college or technical college. Applications are available in the Counseling Office or from the Pathway Partners Director. Deadline for applications is Thursday, March 15, 2012. Selection Criteria 1. 2. 3. 4. 5. 6. Dependents of a scholarship committee member are ineligible. Financial need. School and extracurricular participation. Academic effort and improvement. Prime consideration is given to students who have not been awarded other scholarships. Special consideration is given to students who demonstrate success at overcoming a disability or other difficult personal situations. 7. Enrollment in Pathway Partners Program for a minimum of three months prior to application for scholarship. A selection committee shall review all applications and appoint one scholarship recipient. Scholarship funds will be made payable in the student’s name to the institution of their choice upon presenting proof of enrollment. If you are uncertain whether you qualify for this scholarship, please see the Pathway Partners Director Mrs. Boon, or School-to-Career Coordinator, Mrs. Fredrick. Application Requirements 1. Completion of the application form that is available from the Pathway Partners Director or the Counseling office. 2. Two letters of recommendation: one from your mentor and one from a teacher, employer, or community member. 3. Unofficial school transcripts should be included in a sealed envelope from your School Counselor. 4. The application, narrative and letters of recommendation should be placed in a sealed envelope addressed to Pathway Partners Scholarship Committee and returned to the Pathway Partners Director by Thursday, March 15, 2012, at 3:00pm. It is the policy of the School District of Marshfield that no person may be denied admission to any public school in this district or be denied participation in, be denied the benefits of or be discriminated against in any curricular extracurricular, pupil service, recreational, or other program or activity because of a person’s gender, race, national origin, ancestry, creed, pregnancy, martial or parental status, sexual orientations or physical, mental, emotional, or learning disability or handicap as required by s. 118.13, Wisconsin Statues. This policy also prohibits discrimination as defended by Title IX of the Education Amendments of 1972, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973. 1 PATHWAY PARTNERS SCHOLARSHIP APPLICATION FORM Name: _________________________________________________________ Address: _______________________________________________________ Phone Number: __________________________ List School and Community Activities ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Planned area of study______________________________________________________ NARRATIVE- Attach your response to the following: 1. Explaining why you are applying for these scholarships please address the following points. How have you shown academic effort and improvement since entering MHS? Please cite examples. What traits do you possess that you believe will aid you in your pursuit of postsecondary education? Please include any factors which would limit your ability to attend a university, college, or technical college or would influence your financial capabilities to do so, i.e. extenuating circumstance such as illness, recent changes in financial support, siblings in college, major financial liabilities, or challenges you have had to overcome etc… 2. Separately please explain in a paragraph or two how your involvement with Pathway Partners has affected your life. 2 BACKGROUND INFORMATION Father’s name ____________________________________________________________ Address_________________________________________________________________ Father’s occupation________________________________________________________ Mother’s name___________________________________________________________ Address_________________________________________________________________ Mother’s occupation_______________________________________________________ Number of siblings___________________ Number of siblings in college_____________ Do you plan to work while in school? ________________ Work experience ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Are you eligible for social security, veterans, or disability benefits? Yes________No_______ (if yes, explain) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ I GIVE PERMISSION TO THE SCHOLARSHIP COMMITTEE TO REVIEW MY CHILD’S ACADEMIC RECORDS. _______________________________________ (Parent’s signature) 3