2015 PSFCU Scholarship Application
FOR OFFICIAL USE ONLY
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Dear Member:
As part of our mission in helping members achieve financial success, the Credit Union
realizes the need for a solid education. Dreams of a higher education are often hindered by
financial difficulties. With these values in mind, the Scholarship Program was created.
The Scholarship Program is open to any PSFCU member (primary owner of the account;
joint owners and children of owners do not qualify) whose account was Opened Prior to
January 1, 2014. Members whose accounts were opened after December 31, 2013 are not
eligible to apply. The PSFCU Scholarship Program is open to students who will continue
studying full or part time towards an undergraduate or graduate degree at an accredited
institution in 2015/2016 with a cumulative Grade Point Average (GPA) of at least 3.0.
(Current high-school students are not eligible). Scholarships will be awarded based on
academic achievements, extracurricular involvement and commitment to the Polish/Slavic
community. The Scholarship Selection Committee may also take into consideration a
candidate’s financial need. All decisions of the Scholarship Committee are considered final.
This year’s goal is to select 80-120 winners who will be awarded $1,000-5,000 scholarships.
The Committee will award at least three $5,000 scholarships. A member is limited to only
one grant during the life of this program.
Please mail 4 copies of your completed, typed application and essays with a single copy of
required documentation no later than March 21, 2015. Applications should be completed in
English only. All Polish documents should have English translations attached. Awards will be
issued directly to the scholarship recipients in the form of a check. The member agrees to
use any scholarship funds awarded only for qualified educational expenses during the
2015/2016 academic year. Incomplete, late, faxed or e-mailed applications will not be
accepted. Mailing instructions and a full listing of required documents are outlined on page 6
of this application.
LAST NAME, FIRST NAME:
1
Personal Information
Last Name, First Name, Initial
Date Of Birth:
/
/
Your Maiden Name/Other Last Names Used in the Past
Place Of Birth:
(Permanent) Address
City, State, Zip
(Alternate) Address
City, State, Zip
Phone (
E-Mail Address:
)
Cellular Phone (
)
PSFCU Member #:
PSFCU Member Since (year):
Have you ever received PSFCU Scholarship?
If so, in what year?
What was your school level at the time:
High-School
Undergraduate
Graduate
Family Background
Father’s (Legal Guardian’s) Name
(Last, First)
Father’s Occupation
Father’s Highest Level of Education
__________________________
________________________
____________________________
Mother’s (Legal Guardian’s) Name
(Last, First)
Mother’s Occupation
Mother’s Highest Level of Education
Your Status in the US:
Citizen/Permanent Resident
Student or other temporary visa
Other
LAST NAME, FIRST NAME:
2
Academic Information
Your Current Status as of spring semester 2015 (Check all that apply):
Full Time Student
Part Time Student
Undergraduate
Graduate
Year in your current program:
Length of your program:
List all Institutions attended since high-school:
School Name
Address
(City, State)
Your current/intended major:
Dates attended
(MM/YY) include expected
graduation dates
GPA
Degree
Earned
Standardized Tests For Undergraduates – *Enter the best result achieved in each section.
If you have not taken standardized tests, please explain briefly why:
SAT Scores*
Math
Critical Reading
Writing
ACT Scores*
Composite Score
English
Reading
Mathematics
Combined Score
Science
Combined English/Writing
SAT II (Subject Tests) – List subjects and best score achieved
Subject and Score
Subject and Score
Subject and Score
Subject and Score
Advanced Placement (AP Tests) – List subjects and score achieved
Subject and Score
Subject and Score
Subject and Score
Subject and Score
Standardized Tests For Graduate Students
GRE
LSAT
Other Graduate Testing
GMAT
MCAT
List your academic distinctions/honors/awards (up to 10) List, in order of importance, academic honors,
awards, distinctions etc. received during the past 4 years (candidates who interrupted their schooling should list
awards received while they were in school).
LAST NAME, FIRST NAME:
3
Extracurricular Involvement -
Please fill in the following three tables. Lists should be in order
of importance. Please enter each activity/achievement only once -- do not duplicate information in the
tables. Please list activities from the last 4 years only. Only information from the tables will be considered by
the Committee. Do NOT send any additional materials.
List membership in up to 8 organizations, professional associations, sport teams etc. Please note the
duration and time intensity of your involvement and any offices held.
Organization Name
Dates of
involvement
(MM/YY-MM/YY)
Time commitment
Offices held
(e.g. hrs/week and
weeks/year)
(brief description)
List your 5 most important extracurricular achievements and briefly describe them.
Achievement
Date
Description
LAST NAME, FIRST NAME:
4
List your 5 most important jobs (above 10 hours/week) or community service (above 50 hours/year)
performed over the past 4 years.
Name of firm/organization
Dates of
involvement
Time
commitment
(MM/YY-MM/YY)
(e.g. hrs/week and
weeks/year)
Description
Which PSFCU sponsoring organization (Polish-Slavic Center, Polish Cultural Foundation in Clark, Polonia of
Long Island, Inc., Polish Supplementary School Council of America, Inc., General Pulaski Memorial Parade
Committee, Alliance of Polish Clubs in the USA, Kosciuszko Foundation, Polish Highlanders Alliance of North
America) are you a member of, and what is the extent of your involvement?
Essays
1) Mandatory. Answer the following essay question (under 300 words) on an attached sheet of paper with your
name. Please describe in detail your connection to the Polish/Slavic community. Include things such as
language study and relevant academic interests, involvement in Polish/Slavic organizations (example: Scouts,
Church, student clubs, music or folk dance groups) as well as community involvement (example: charity work,
contributions to Polish/Slavic media and culture, help with Polish/Slavic institutions and events). How do you plan
to continue your involvement in the future?
2) Mandatory. Answer the following essay question (under 300 words) on an attached sheet of paper with your
name. What do you hope to accomplish after finishing your current schooling?
3) Mandatory if you want your financial need to be considered by the committee for extra points. Please write a
short statement (under 100 words) explaining your need AND submit financial documentation:
1) Copy of your SAR, and 2) documentation stating your complete cost of attendance and other grants received
(e.g. Bursar’s statement and Financial Aid Letter). If you did not file FAFSA or do not qualify for financial aid,
please contact PSFCU for instructions. Please include your name on the attached page.
LAST NAME, FIRST NAME:
5
Supporting Materials & Mailing Instructions
Along with this application please submit the following:
1) Official transcripts from ALL academic institutions attended since high-school. Current college freshmen
must send current college transcript AND a copy of their high-school transcript. Minimum cumulative
Grade Point Average (GPA) of at least 3.0 is required.
2) Copy of standardized test results (SAT, SAT II, GRE, GMAT, ACT, etc.)
3) Two letters of reference, at least one of which must be an academic recommendation written by a
professor who has taught the candidate. An application without an academic recommendation will be
considered incomplete. Please note that recommendations from family members are not permitted.
Please indicate below the names and contact numbers of the people whom you asked to write your
letters.
4) If changing schools by September 2015 send a copy of your acceptance letter from the school that you
plan to enroll in. (if this is not available by March 21, please send it as soon as possible, but no later than
April 6).
5) Applicants should utilize tables on the application form. No extra materials (e.g. resumes, extracurricular
activity lists etc.) will be considered by the committee.
6) Applicants must be PSFCU members with accounts opened on or before December 31, 2013.
7) Scholarship winners will be required to present a proof of enrollment for the fall term before receiving their
grants.
8) Please note: PSFCU employees are not eligible for the PSFCU Scholarship Program.
9) Please mail 4 copies of your completed application and essays together with a single
copy of the supporting documentation to:
PSFCU Scholarship Committee
9 Law Drive
Fairfield, NJ 07004
IMPORTANT! Faxed, e-mailed and hand delivered (left in PSFCU branches) applications will not be considered.
References
Name
Title
Institution
Academic:
Other:
Telephone #
(
(
Number of
years
known
)
)
Other
How did you learn about the PSFCU scholarship? (Check all that apply)
Friend or Family Reference
Media
Type (Newspaper, Internet, PSFCU Branch, PSFCU Newsletter)
_______________
Name (e.g. Nowy Dziennik, Fast Web)
_________________________
Other:
__________________________________________________
Signature _______________________________
Date: ____/_____/_____
(MM/DD/YY)
LAST NAME, FIRST NAME:
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