2015-2016Application
Date Received:________
Packet Complete: _______
office use only
The James H. and Connie M. Maynard Scholarship Application
James and Connie Maynard and the College of Education established the Maynard Scholarship at East Carolina
University on May 31, 2006. This four year $20,000 scholarship is awarded to selected outstanding high school
seniors each year. The scholarship is modeled after the N.C. Teaching Fellows Scholarship and as so,
recipients will be expected to teach in a public, charter or government school for four years in one of the stated
counties following graduation. Individuals have up to seven years to complete this requirement. The Maynard
Scholarship is administered from the ECU NC Teaching Fellows office.
Application Instructions
To apply for the Maynard Scholarship, please complete the attached application form and submit it to the
address below postmarked by Wednesday, January 28, 2015. Late applications and incomplete applications
will not be accepted.
Requirements
Must be a current resident of North Carolina residing in one of the specified counties
(listed on page 1 of application)
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 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 (listed on page 1 of application)
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 7th (students will be notified about their interview
time by the Maynard Scholars office).
Applicants selected for an interview will be notified by email
Please return completed application, along with 1040 tax form from 2013, to the below address:
ECU Maynard Scholarship Program
College of Education, East Carolina University
Rivers 138, Mail Stop #124
Greenville, NC 27858
The James H. and Connie M. Maynard Scholarship Application
Application Instructions
Please complete the attached application form to apply for the Maynard Scholarship and mail it to the ECU
Maynard Scholars Office. All applications must be complete and postmarked by Wednesday, January 28,
2015.
Personal Information (Please type or write legibly)
Name:
First:
______________________ Middle: _________________ Last: ___________________
Address:
________________________________________________________________
City:
__________________State: __________ Zip: _________ County: ___________
Home Phone: ____________________
Alternate Phone: _________________________
E-Mail Address: __________________________________
Names of Parents/Guardians with Whom You Reside – Please list each and send the 2013 year 1040 tax form for your
household.
_____________________________________
__________________________________________
Last Name, First Name
Last Name, First Name
Have you officially applied to East Carolina University? If so, have you been accepted?
______________________________________________ Acceptance Date: _____________________
Please circle the county in which you currently reside. Recipients will be required to teach in one of these
counties upon graduation.
Beaufort ∙ Bertie ∙ Bladen ∙ Brunswick ∙ Camden ∙ Carteret ∙ Chatham ∙ Chowan ∙ Columbus ∙ Craven ∙
Cumberland ∙ Currituck ∙ Dare ∙ Duplin ∙ Durham ∙ Edgecombe ∙ Franklin ∙ Gates ∙ Granville ∙ Greene ∙
Halifax ∙ Harnett ∙ Hertford ∙ Hoke ∙ Hyde ∙ Johnston ∙ Jones ∙ Lee ∙ Lenoir ∙ Martin ∙ Nash ∙ New Hanover
∙ Northampton ∙ Onslow ∙ Orange ∙ Pamlico ∙ Pasquotank ∙ Pender ∙ Perquimans ∙ Person ∙ Pitt ∙ Robeson ∙
Sampson ∙ Tyrell ∙ Vance ∙ Wake ∙ Warren ∙ Washington ∙ Wayne ∙ Wilson ∙
Maynard 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.
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 James H. and Connie M. Maynard 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 Maynard 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 Maynard Scholar.
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Signature: _________________________________ Date: _____________________
0
