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: _____________________