2015-2016 Application
Date Received:________
Packet Complete: _______
office use only
The Pat and Lynn Lane Scholarship Application
The Lane scholarship is a four year $20,000 scholarship awarded to an outstanding high school senior who
wants to pursue a career in teaching. The scholarship is modeled after the ECU Maynard Scholarship and as
such, recipients will have a required on campus living component for the first year, a four year programmatic
component and specific criteria for receiving funds.
Application Instructions
To apply for the Lane Scholarship, please complete the attached application form and submit it to the address
below by Wednesday, January 28, 2015. Late applications and incomplete applications will not be accepted.
Requirements

Must be a current resident of North Carolina

Must have a minimum score of 1,000 on the SAT or 22 on the ACT

Must have an unweighted GPA of 3.0 or better

Must be admitted to East Carolina University by February 23, 2015

Must intend to teach K-12 upon completion of an undergraduate program for a minimum of 4 years in
one of the ECU Latham Clinical Schools Network counties.

Must provide high school transcript from 1st semester of Senior Year (if you can’t obtain this by the
application deadline, this may be brought to the interview, as long as you note this on the application)

Must provide 1040 tax form for parent/guardian with whom applicant resides from year 2013
(We must receive this in order to completely process the application)

Must include typed essay, addressing the prompt listed on the application below

Must provide at least two letters of recommendation from someone in your high school or community.
These letters must speak about your academics or character and must be signed and sealed in an
envelope and included with the completed application. Please use the attached reference form.
Interviews

Will be conducted at ECU on Saturday, February 7, 2015 (interview times will be assigned by the
Maynard Scholars office).

Applicants selected for an interview will be notified by email and mail.
Please return completed application, along with 1040 tax form, to the below address:
ECU NC Teaching Fellows & Maynard Scholars Program
College of Education, East Carolina University
Rivers 138, Mailstop 124
Greenville, NC 27858
The Pat and Lynn Lane Scholarship Application
Application Instructions
Please complete the attached application form to apply for the Lane Scholarship and submit by
Wednesday, January 28, 2015.
Requirements
 Must be a resident of North Carolina
 Must have a minimum score of 1,000 on the SAT or 22 on the ACT
 Must have an unweighted GPA of 3.0 or better
 Must be admitted to East Carolina University by February 23, 2015
 Must intend to teach K-12 upon completion of an undergraduate program for a minimum of 4
years in one of the specified counties listed below
 Must provide 1040 tax form for parent/guardian with whom applicant resides from year 2013
(We must receive this in order to completely process the application.)
Personal Information (Please type or write legibly)
Name:
First:
______________________ Middle: _________________ Last: ___________________
Address:
________________________________________________________________
City:
__________________State: __________ Zip: _________ County: ___________
Home Phone: ____________________
Alternate Phone: _________________________
E-Mail Address: __________________________________ Are you a US Citizen? ______________
Names of Parents/Guardians with Whom You Reside – Please list each and send the 2012 year 1040 tax form for your
household.
_____________________________________
__________________________________________
Last Name, First Name
Last Name, First Name
Applicant MUST be willing to teach in one of the Latham Clinical Schools Network systems listed below
in order to fulfill the teaching requirement of the scholarship.
Beaufort, Bertie, Camden, Carteret, Clinton City, Craven, Cumberland, Dare, Duplin, Edenton-Chowan,
Edgecombe, Elizabeth City/Pasquotank, Franklin, Gates, Granville, Greene, Halifax, Harnett, Hertford, Hyde,
Johnston, Jones, Lee, Lenoir, Martin, Nash/Rocky Mount, Northampton, Onslow, Pamlico, Pitt, Roanoke
Rapids, Sampson, Tyrrell, Vance, Warren, Washington, Wayne, Weldon City, and Wilson.
Lane Application Page 2
Educational Information
High School: _____________________
Date of graduation: ____________________
Class Rank:
GPA (Weighted): _________ (Unweighted): _________
_____ Class Size: _____
SAT Composite* (Math/Verbal): ___________
ACT Composite Score: ________
*Use highest math and verbal scores to determine composite.
*List highest ACT score if taken more than once.
Please do not include the new writing portion of the SAT in this composite.
Intended Major at ECU: _______________________________ (Ex: Math, Middle Grades, Elementary, PE, Music Ed.)
Have you officially been accepted to ECU? _______________ Date of Acceptance: ___________________
School/Community Activities
Please attach a list of all your school/community activities and the roles and responsibilities that you hold in
each. You may also include employment information in this section of the application.
Hobbies & Special Interests
Please describe
_________________________________________________________________
_________________________________________________________________
Honors & Awards
(Please list)
Academic:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Athletic:
_________________________________________________________________
_________________________________________________________________
Other:
_________________________________________________________________
Essay Question
Please attach a typed essay, focusing on experiences that have influenced your decision to pursue a career in
teaching and how these experiences will help you in this career choice.
References
Name and Job Title of Recommendation 1: _______________________________________
Name and Job Title of Recommendation 2: _______________________________________
The Pat and Lynn Lane Scholarship Recommendation Form
Please complete the Recommendation Form and put it in a sealed and signed envelope and return to
the applicant to be submitted with the scholarship application. The reference is confidential.
Section 1: To be completed by the Scholarship Applicant
Applicant Printed Name: _____________________ Recommendation Printed Name: ___________________
Section 2: To be completed by the Reference
Capacity and time you have known the applicant:
____________________________________________
____________________________________________
The applicant listed above as applied for a prestigious $20,000 scholarship to go into the field of Education at
East Carolina University. Please comment on the applicant’s ability to represent the field of education as an
ECU Lane Scholar, to promote the teaching profession, and to serve as a leader in the University and
community. Include any strengths or highlights relating to leadership experience or volunteering and why you
feel that this applicant should or should not be selected as an ECU Lane Scholar.
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Do you feel the applicant would be a good representative of East Carolina University College of Education?
________________________________________________________________________________________
Signature: _________________________________ Date: _____________________