National Society Daughters of the American Revolution
Longs Peak Chapter
Wilma Dunn Student Scholarship ($1000)
GUIDELINES:
1. The student must be a United Sates Citizen and a college bound, graduating senior from
within the geographic area of the St. Vrain Valley RE 1J School District; or a graduating
homeschooled senior from within the St. Vrain Valley RE 1J geographic area; or a close
relative of a Longs Peak Chapter NSDAR member; or a 16-18 year old receiving a GED,
living in the same geographic area, who has been accepted to an accredited college or
university.
2. Only applications completed in detail and submitted in one package will be considered. Only
the recipient will be notified. Incorrect applications will be discarded.
3. Chapter award will be placed on deposit in recipient’s name with the college or university of
the applicant’s choice; any unused portion will be returned to Longs Peak Chapter.
4. The award will be based on academic excellence, commitment to field of study and
demonstrated financial need. No affiliation with DAR is necessary. All application materials
are due to the Longs Peak Chapter Scholarship Chairperson by the deadline specified on the
cover letter. The award will be made at the Chapter’s May luncheon.
INSTRUCTIONS:
The application package must be complete and arranged in the order described below. All transcripts,
letters of recommendation and other required documents must be sent in a single package as described to
the chairperson by the deadline. Word processed applications and statements are preferred.
1. Scholarship Application
2. Financial Need Form
3. On a single page, applicant must prepare a statement setting forth study or career objectives
and reasons for these choices. (Include academic studies and/or struggles, family and
personal issues or hardships, job or community involvement which may have influenced your
decision to follow these goals.)
4. Transcript of high school grades
5. Dated and signed letters of recommendation from at least one teacher and one non-school
and non-family member, but not more than three persons in authority who are familiar with
student’s work. Letters may cover the applicant’s ability, work habits, integrity and
potential.
6. Photocopy of birth certificate or naturalization papers.
7. Application package should be stapled in the top, left-hand corner. Number of pages in the
package must NOT exceed eight.
Please send applications to be received by Feb. 29, 2016 to:
Kristine Scott
Chairperson NSDAR
2617 Martingale Dr.
Berthoud CO 80513
National Society Daughter of the American Revolution
Longs Peak Chapter
Wilma Dunn Student Scholarship
Application Form
Name of Student: _______________________________________________________________
Street Address: _________________________________________________________________
City, State, Zip: ________________________________________________________________
Email address: _________________________________________________________________
Telephone number(s) home: ___________________________cell:________________________
Social Security Number: (will be needed from recipient of award only)
College or university the applicant plans to attend: _____________________________________
Major or study of interest: _________________________________________________________
Class rank/class size: ______________________Cumulative GPA/Scale:___________________
Test Scores: SAT: ______________ACT:______________ please include unofficial transcript.
Volunteer Activities (home or community):
Work/School Activities:
Refer to the scholarship guidelines and instructions page for detailed instructions for applying for this
scholarship.
I attest that all information in this application and all attachments are a true and accurate record.
____________________________________________
Signature of Father or Guardian
______________________
Date
____________________________________________
Signature of Mother or Guardian
______________________
Date
____________________________________________
Signature of Applicant
______________________
Date
If you are a winner, the Scholarship Committee would like to send an article to your local newspaper. Your signature above
is considered an agreement to allow Longs Peak Chapter, NSDAR to use information from this application for publicity
releases. Please provide the newspaper’s name and address:
Name
Address
National Society of Daughters of the American Revolution
Longs Peak Chapter
Wilma Dunn Student Scholarship
Financial Need Form
Father or Guardian:
Name: __________________________________________________
Address: _________________________________________________
City, State, Zip__________________________________________________
Employer: ________________________________________________
Position: __________________________________________________
Annual Income: $_________________________
Mother or Guardian:
Name: ___________________________________________________
Address: _________________________________________________
City, State, Zip: ___________________________________________
Employer: ________________________________________________
Position: _________________________________________________
Annual Income: $_____________________________
Other sources of financial aid or scholarships received:
The parent/guardian shall prepare a statement summarizing the family’s obligations and resources. The statement
needs to illustrate the applicant’s need for financial assistance. Statement follows:
I attest that all information in this application and all attachments are a true and accurate record.
___________________________________
Father/Guardian Signature
____________________________________
Applicant’s Signature
__________________________________
Mother/Guardian Signature