Scholarship Application Instructions for 2016 - 2017
Deadline: March 11, 2016
To consider your application, the NJLA Scholarship Committee will require the following
materials. All accompanying materials must be postmarked by March 11, 2016. It is the
applicant’s responsibility to ensure that all requested materials are received timely.
1.
The completed online application form submitted no later than March 11, 2016.
Application URL:
http://njlamembers.org/content/njla-scholarship-application
Including the following to be submitted online with the application:
A 150-250 word essay explaining your choice of librarianship as a profession.
A résumé or CV that includes your work and education history, along with any
internships or volunteer work.
2.
Official transcripts from ALL colleges and universities attended (undergraduate and
graduate). Please have transcripts sent to you. (You will include the sealed copies of
your transcripts in your application packet—see below.)
3.
Two letters of recommendation. Submit two letters of recommendation from
individuals from your professional, business, or educational history who can comment
specifically on your ability to excel as a graduate student in library and information
science, as well as within the profession. Letters of recommendation must be in the
original sealed, postmarked envelope, and include the reference’s contact
information, including mailing address, email address, and phone number if mailed.
Letters of recommendation can also be emailed by the individual writing the
recommendation, to: ScholarshipNJLA@gmail.com
All applicants must agree to be available for an interview on Friday, April 8, 2016 at Rutgers
University in New Brunswick, NJ, if selected.
The essay, résumé or CV, sealed official transcripts, and sealed letters of recommendation
should be sent in one packet to:
Debbie Maynard
NJLA Scholarship Committee Co-Chair
Pequannock Township Public Library
477 Newark Pompton Turnpike
Pompton Plains, NJ 07444
Scholarship Application for 2016-2017
Name:
(Last)
(First)
(Middle initial)
Current Address:
(Street)
(City, State, Zip)
(Street)
(City, State, Zip)
Permanent Address:
(if different)
Email:
Phone:
GRADUATE DEGREE in Library and Information Science
Are you currently attending library school?
Yes
No
Have you been accepted into a program?
If yes, please specify institution:
If yes, please specify:
(Institution)
(Credits completed)
On campus Online
Full time
Part time
Anticipated year of graduation
Degree Objective: Master’s
On campus Online
Full time
Part time
Anticipated year of graduation
Degree Objective: Master’s
Doctorate
Doctorate
If not yet accepted, where have you applied?
1.
2.
EDUCATIONAL BACKGROUND (list ALL undergraduate and graduate institutions attended, with most
recent first)
College or Institution
Year(s)
Degree
Major
GPA
1.
2.
3.
4.
DIVERSITY
NJLA offers an Ethnic Diversity Scholarship. If you believe you would be eligible for this scholarship,
please indicate your basis of eligibility.
African American
Latina/Latino/Hispanic
Another category not listed (describe)
Asian/Pacific Islander
Native American/Native Alaskan
INCOME TAX DATA (Most recently filed tax return)
Adjusted Gross Income from ________(year) tax return
$
Total federal income tax paid
$
State or local income tax paid (total all jurisdictions)
$
Filing status:
Single
Married, filing
jointly
Married, filing
separately
Head of
household
DEPENDENTS
Do you claim dependents on your tax return?
Yes
No
If yes, please specify:
Live at
Home (Y/N)
Age
School Name
Public or
Private?
Anticipated
Tuition Costs
Financial Aid/
Scholarships/Loans
1.
2.
3.
4.
5.
More than 5, please list on reverse.
ASSETS
Estimated Current
Amount or Value
Amount Owed
Cash, savings, checking
$
$
Home
$
$
Other real estate and investments
$
$
Business and farm
$
$
Other assets (describe)
$
$
CURRENT EMPLOYMENT DETAIL
Applicant:
Employer
Job Title
Date Employed
Current Salary
Full Time or
Part Time?
Current Salary
Full Time or
Part Time?
Spouse or Domestic Partner (please write N/A if not applicable)
Employer
Job Title
Date Employed
Will spouse or domestic partner be a student during the 2016-2017 academic year?
Institution
Yes
Graduate Undergraduate
Financial Aid Expected
Grants: $
Loans: $
No
OTHER FINANCIAL RESOURCES – 2016-2017
Scholarships, Grants, Fellowships
Applied
Awarded
1.
2.
3.
Financial assistance from family and others
$
STUDENT AND SPOUSE/DOMESTIC PARTNER'S ANTICIPATED INCOME AND BENEFITS –
2016-2017 (Please write N/A if not applicable)
Academic Year
2016-2017
Summer 2016
Applicant's anticipated taxable income (not
including financial aid)
Spouse/domestic partner's anticipated
taxable income (not including financial aid)
Applicant's Social Security educational
benefits (if applicable)
Applicant's veteran's educational benefits
$
$
$
$
$
$
$
$
INDEBTEDNESS
Total Owed as of
December 2015
Amount to Be Paid in
Academic Year 2016-2017
Applicant's student loans
$
$
Spouse/domestic partner's student loans
$
$
Other debt (credit card, home equity line of
credit, personal loans)
$
$
MONTHLY HOUSING EXPENSES
Rent or mortgage payment (monthly)
$
Real estate taxes
$
Homeowner’s or renter’s insurance, annually
$
Other
$
TRAVEL EXPENSES (please write N/A if not applicable)
Automobile make, model, and year
Monthly auto payment (including insurance)
$
Amount owed on automobile
$
Anticipated 2016-2017 monthly mass-transit costs
$
ADDITIONAL FINANCIAL CONSIDERATION
Use this box to explain any other financial consideration that you would like the committee to use
in evaluating your need:
PREVIOUS NJLA SCHOLARSHIP RECIPIENT?
Did you previously receive a New Jersey Library Association scholarship?
(Note: Previous applicants or award recipients are eligible to reapply.)
Yes
No
OPPORTUNITY TO SERVE
Scholarship recipients are given an opportunity to be of service to NJLA. Would you be
interested in this? (Your answer is not a factor in the selection process)
Yes
No
STATEMENT: All the information on this application is true and complete to the best of my (our)
knowledge. If requested by an authorized official, I (we) agree to provide the Scholarship
Committee documentation regarding the information I (we) have provided on this form and
acknowledge such proof may include a copy of relevant federal, state, and local tax returns. We
acknowledge that failure to present such documentation, when asked, will result in
disqualification of my application and no aid will be granted.
Applicant's Signature
Date
Spouse's or Domestic Partner's Signature
Date
I AGREE TO BE AVAILABLE FOR AN INTERVIEW on Friday, April 8, 2016, at Rutgers
University in New Brunswick, NJ (RAIN/SNOW DATE Friday, April 15, 2016).
(Signature)
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