Stephen
Stallworth
Foundation
Scholarship Application
The Stephen L. Stallworth Merit Scholarship
Several Scholarships Ranging from $500 - $2,500.
For College Bound High School Seniors. All Fields of Study are Available. Scholarships
Post Feb 2nd / DEADLINE FOR ALL SCHOLARSHIPS June 1st
The organization will award Scholarships based on:
1. Criteria and Rules of Eligibility:
a. Must Have A Minimum GPA of 3.0. All Fields of Study are Applicable.
b. Must Be a Texas Resident.
2. Recipients will be selected by the Foundations Scholarship Committee.
3. Award will be made directly to individual. Recipient must provide proof of enrollment at time
scholarship is presented and must remain in school for the duration in order to qualify for
additional assistance.
4. Awards will be made available to children of members and employees of the foundation. No
preference will be made based on position, length of employment, or salary.
a. No conditions of employment to the Foundation will be made of recipients upon
graduation, and award will be continued if employment or membership ends.
5. Scholarship Application must be mailed along with a list of 3 references. (Guidance
Counselor, Community Leader, Teacher or acceptable references)
Send All Inquiries to:
Stephen Stallworth Foundation
P.O. BOX 16603
Fort Worth, Texas – 76162
Date________________________________
Interviewed by ____________________________________
Scholarship Application
Personal Information
Name of Applicant_____________________________________________________________________________
Date of Birth__________________________________________________________________________________
E-mail_________________________________________ Telephone No. _________________________________
Present Address ______________________________________________________________________________
City_______________________________________ State ___________________ Zip_______________________
Education
Name of School ____________________________________ Date of High School Graduation____________________________
Location:______________________________________________________ Telephone No. ____________________________________
Cumulative Grade Point Average_________________________________ On a scale of _________________________________
Rank In Class________________________ Out of how many? _______________________
SAT Results: V _______ M _______ W _______ TOTAL: ______ and/or ACT: _____________
HONORS/AWARDS:
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ACADEMIC HONORS:
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COMMUNITY/ EXTRA-CURRICULAR ACCTIVITIES:
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SPECIAL CONSIDERATION
(can include some of the following: death of a student’s parent or guardian; disability of student; other unusual
expenses or circumstances)
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Personal Statement
Provide a brief statement of your educational and career goals and experiences, as well as your
professional aspirations. Indicate in which area(s) of study you are considering making your career,
and specify how your current academic program and your overall educational plans will assist you
in achieving your goal.
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References
Name
Relationship
Telephone No.
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Please Enclose (3) Letters of Recommendation along with Official Copy of High School Transcript.
Other Information
PLEASE PROVIDE THE FOLLOWING:
A. Completed Scholarship Application with attached photograph (optional). Please note if recipient is selected a recent
photograph will be required by the Foundation.
B. Letter of recommendation from a high school teacher, guidance counselor, principal or vice-principal. If the letter is
submitted by a teacher or guidance counselor, it must be co-signed by the principal or vice-principal and be written
on school letterhead.
C. A complete, official, school-issued high school transcript of grades. If for some reason this is not available (as in the
case of a three-year graduation program), submit a letter of explanation. Unofficial transcripts will NOT be
accepted.
Photocopies are not acceptable.
D. A copy of your diploma/graduation certificate and indication of class rank.
E. A copy of an acceptance letter from an approved college or university (see criteria in the introductory paragraph).
F. A copy of your scores on the SAT. If this test is not given in your area, provide the scores from the comparable test
that is given. Other scholastic aptitude test results may be submitted at the discretion of the applicant. G. A personal
statement.
H. A stamped, self-addressed envelope. (we will notify applicants by mail)
Acknowledgement
I hereby affirm that the above stated information is true and correct to the best of my knowledge and that the
personal statement I have provided is my work alone. I also consent that my picture may be taken and used for any
purpose deemed necessary to promote the Stephen Stallworth Foundation scholarship program.
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Applicant’s Signature
Parent/Legal Guardian (if under 18)
Date
Date
NO FAXES ACCEPTED
APPLICATIONS RECEIVED AFTER DEADLINE WILL NOT BE ACCEPTED
Deadline for This Application is June 1, 5:00 pm. No Exceptions! Final complete official transcripts must
arrive no later than June 15th.
Winners will be notified in August and will be required to send a recent photograph to be used by the Foundation. Recipients will
also be required to attend the Stephen Stallworth Foundation Scholarship Reception to be held in September.