FENTRESS COUNTY HISTORICAL SOCIETY
(F.C.H.S.)
Application for Scholarship
Deadline: March 1
I, ____________________________, am a senior at _____________________________.
I wish to apply for the Fentress County Historical Society (F.C.H.S.) Scholarship.
I understand that the scholarship is competitive and that the determination for the scholarship
award will be made by the Fentress County Historical Society. I further understand that if I
am chosen as the scholarship recipient, the following terms will apply:
The amount of the F.C.H.S. Scholarship is $500.00 for the year beginning with the Fall
Semester following the date of application and approval by the Fentress County Historical
Society Scholarship Committee. Any student who is awarded the F.C.H.S. Scholarship may
apply for continuation for up to four years by completing an Application for Renewal of
Scholarship and meeting the F.C.H.S. Scholarship Renewal Guidelines. However, priority
will be given to first-time applicants. In no case will any student be considered to receive the
scholarship for more than four school years.
Guidelines for Qualification to Receive Scholarship
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The applicant must have attended Fentress County Schools for at least ten years and
must have attended all four years of high school at either Clarkrange High School or
York Agricultural Institute.
The applicant must have a high school GPA of no less than 3.0 on a 4.0 point scale
(or its equivalent).
The applicant must be pursuing a Batchelor’s level degree and must present proof of
enrollment (acceptance letter) in an accredited Liberal Arts College or University.
Priority may be given to applicants who are preparing for a major or minor in the
fields of History or Social Studies.
The applicant must be enrolled as a full-time student with a minimum of 12 credits in
the first semester.
The application must be received by the F.C.H.S. Scholarship Committee no later
than March 1.
I understand and agree to the terms of the scholarship.
___________________________
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Signature of Applicant
Date
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FENTRESS COUNTY HISTORICAL SOCIETY
(F.C.H.S.)
Application for Scholarship
Deadline: March 1
Name of Applicant ________________________________________________________
Mailing Address _________________________________________________________
City ____________________________________ State _____ Zip Code ____________
Home Phone _____________ Cell Phone ____________ Email ___________________
Name of Parent(s) or Guardian(s) ____________________________________________
Mailing Address of Parent(s) or Guardian(s) ___________________________________
Occupation _______________ Employer ______________________________________
School Information
Schools Attended in Fentress County
Years
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_______________________________________________________________________
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Date of High School Graduation ________________ High School GPA _____________
Class Rank _________
ACT ___________
or
SAT ___________ score
College/University you plan to attend ___________________Degree sought _________
Date You Begin as a College/University Student ________________________________
Courses of study you are considering (major/minor) _____________________________
_______________________________________________________________________.
Career you are considering _________________________________________________.
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School Activities, Awards and Honors
List those school activities in which you have been an active participant during the past four
years. List any awards and honors received.
Activity
Number of years participated
Offices held
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Community Activities
List community activities, organizations or clubs in which you have been an active
participant during the past four years (e.g., Red Cross, church, volunteer work, etc.).
___________________________________________________________________________
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Recommendations
Fill out the top portion of the two attached scholarship recommendations and give to
two individuals not related to you, but who know you well (May be a teacher, coach,
advisor, minister, etc.). Ask them to complete and mail to address on form.
Personal Interview
The F.C.H.S. Scholarship Committee may request a personal interview.
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ESSAY
Write a 250 to 300 word essay stating why you want to attend college and what it will mean
to you, to your family, and to your community. Tell how you have been helped to reach this
milestone in your life and who has influenced you and guided you in your development (e.g.,
family members, teachers, ministers, neighbors, etc.). Tell why you need this scholarship
and how it will benefit your educational goals. Include one paragraph describing your future
plans following completion of college/university. Use back of page if necessary.
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This application must be signed and dated by student and parent(s) or guardian(s).
Student Signature __________________________________
Date _____________
Parent/Guardian Signature(s)
__________________________________
Date _____________
__________________________________
Date _____________
Attach your acceptance letter from the college or university you will be attending, your
high school transcripts and your essay to this application and mail to:
FENTRESS COUNTY HISTORICAL SOCIETY
P. O. Box 1431
Jamestown, TN 38556
Attention: FCHS Scholarship Committee
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FENTRESS COUNTY HISTORICAL SOCIETY
(F.C.H.S.)
Scholarship Recommendation
Name of Applicant ___________________________________________________________
Mailing Address _____________________________________________________________
City _______________________________
State ______
Zip code ____________
Phone ________________
_________________________________________
___________
Applicant’s Signature
Date
To the person rating the above student: This student is applying to the Fentress County
Historical Society for an academic scholarship. Preference is given to applicants whose
application and recommendations are received by March 1.
Please rate this applicant on a scale of 1 to 5, with 1 being low and 5 being high.
Attendance at work or in school
Ability to get along with others
Willingness to cooperate
Courtesy and consideration
Ability to learn
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Personal Accountability
Dependability
Personal Initiative
Responsibility
Studious nature
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How long have you known the applicant? ________________________________________
In what relationship?_________________________________________________________
Describe briefly why this applicant should be considered for this scholarship. (You may
attach a letter of recommendation if preferred _____________________________________
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__________________________________________________________________________ .
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Signature
_______________________
Title or Position
Company or organization ____________________________
Thank you! Please mail to: FCHS Scholarship Committee
c/o Fentress County Historical Society
P. O. Box 1431
Jamestown, TN 38556
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Date
Phone (___)-____-_____