Christopher David Bush Memorial
Scholarship
2014 Application
Objective: To honor the memory of Chris Bush (1987-2010), an alumnus of Mandeville High
School, Class of 2006.
Scholarship Program
Donate to a graduating male senior of Mandeville High School a one-time award of $250 or
more depending on fund raising efforts, to be used towards his expenses in attending the
college/university of his choice.
Criteria
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Applicant must have been elected to the National Honor Society by the deadline for
application.
Award is based on academic record, extra-curricular activities, and personal goals.
Applicant must be male.
Applicant must be a graduating senior from Mandeville High School, and must be
accepted into a college or university at the time of receiving the award.
Procedures
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To apply, the student must fill out and sign this form and submit a copy of his most
recent academic transcript. One additional single-sided page is permitted, but not
required.
The application will be reviewed by the Scholarship Committee.
The Scholarship Committee will be chaired by a member of the Bush family, and will
also consist of members of the faculty/administration of MHS plus other persons from
the Covington-Mandeville community to be chosen annually by the Bush family, for a
maximum total of 5 persons.
The Scholarship Committee will advise Mandeville High School of its intended Award
Recipient on or before April 29, 2014.
In the event of a tie, the award will either be shared between the two parties or awarded
to both recipients at the sole discretion of the Scholarship Committee Chairman.
The award will be presented by Mandeville High School during at its Awards Night.
Deadline to apply: April 18, 2014.
Personal Information
Date of Application__________________________________________________________
Full name_________________________________________________________________
Mailing Address ____________________________________________________________
Telephone Number__________________________________________________________
Email address_____________________________________________________________________
Academic Record
Elected to NHS on (date) _______________________________________________________
FavoriteSubject(s)_____________________________________________________________
___________________________________________________________________________
GPA as of December 31, 2013 __________________________________________________
(Please attach copy of most recent transcript/report card)
Extra-Curricular Activities
List Individual and Team Sports (examples: tennis, soccer, scuba, golf) & state if you play them as part of
a Mandeville area team):
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List Community Service (examples: scouting, tutoring, food pantry, fundraising, religious organization
volunteer activities) & state if you provide these services as part of a Mandeville area program:
____________________________________________________________________________________
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Personal Goals
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Statement & Signature
In applying for this scholarship, I hereby state that I intend to use these funds to pay a part of my
expenses in attending the college/university of my choice.
Signature ____________________________________________________________________
Printed Name _________________________________________________________________
Date Signed __________________________________________________________________
DAVID BUSH MEMORIAL SCHOLARSHIP 20