Rosa Parks Scholarship Foundation
IMPORTANT
PLEASE READ THIS FIRST!
This is a Microsoft Word form/document. Use your “Tab” key to move through this
form. You should do a “File Save As” to make a copy on your computer. You can use this
electronic form to complete your application, and then print the application and mail it.
Or, print the form and complete it by typing.. Do a “File – Save As” before you start to
save a master copy, then save your completed application under a second name.
DO NOT E-MAIL THE APPLICATION BACK - THE COMPLETED APPLICATION
MUST BE MAILED (COMPLETE WITH SIGNATURES AND ATTACHMENTS).
NOTE: Applications MUST be typed.
Handwritten applications will not be accepted/reviewed.
Rosa Parks Scholarship Foundation
The Rosa Parks Scholarship Foundation offers a $2,000, non-renewable
scholarship to graduating seniors. Winners are selected on the basis of
scholarship, leadership, financial need, and dedication to the civil rights principles
of Rosa L. Parks, whose historic stand against racial prejudice in 1955 brought
her national recognition. The Foundation was established in 1980 to provide
equal-opportunity scholarships to Michigan high school seniors.
Scholarships to be applied to first year of college only.
APPLICANTS MUST:
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Graduate by August 2013.
Have GPA of 2.5 or above.
Describe financial need.
Complete application form and essay.
Document community activities.
Confirm admission to university or college prior to August 2013.
Furnish official copies of high school transcript and ACT or SAT results
Furnish 3 letters of recommendation (at least one from a school representative; also suggest clergy,
community and/or civic representative).
ALL REQUIREMENTS MUST BE MET, OR APPLICATION WILL NOT BE CONSIDERED
DEADLINE - APPLICATIONS MUST BE POST MARKED BY: March 1, 2013
Applications also available on our web site:
rosaparksscholarshipfoundation.org
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IMPORTANT TIPS
Applications are reviewed and evaluated in various categories/ areas - on a weighted average (points awarded
in each category). Failure to complete any portion of the application greatly reduces your chance of being
awarded a scholarship. For example, failure to list community service will lower overall points – possibly
enough to eliminate you from competition. Examples of categories are:
Application (complete/neat) - Scholastic Achievement, SAT/ACT - Financial Need
Community Service - Support Letters - Academic Goals - Future Plans - Essay
Other Suggestions/Recommendations
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Make sure your cumulative grade point average appears on your transcripts.
Be neat! APPLICATION MUST BE TYPED.
Have someone proofread your application and essay, so you make a good impression.
Send only material requested - do not include copies of awards, certificates, etc.
Please mail in flat envelope (don’t fold, don’t staple).
DO NOT send letters of recommendation or transcripts in a sealed envelope.
Meet deadlines! Take responsibility for mailing your own application - schools are sometimes late getting
the applications in the mail. Make sure everything is in one envelope - don't mail items separately.
Judging results will be e-mailed to applicants. Winners will be listed on web site (mid-May).
Rosa Parks Scholarship Foundation
(MUST BE TYPED)
Personal:
Name:
Address:
City/State/Zip:
Date of Birth:
Employer - Position/Hours-Per-Week:
Education:
High School:
Overall/Cumulative Grade Point Average (minimum 2.5):
ACT and/or SAT score:
ACT:
SAT:
Major area(s) of study:
Extracurricular Activities (school, clubs, athletics):
Home Phone:
E-Mail:
Place of Birth (State):
Graduation Date:
Based on a GPA system of:
MEAP Test:
Yes
No
University/college(s) to which you have been accepted for admission:
University you plan to attend:
Education Plans
Educational Goals:
College Major:
College Minor:
Career Plans:
Activities / Awards:
Community Service/Volunteer Activities (church, home, etc.)
Honors and Awards:
Essay:
On a separate sheet of paper, please write an essay of 200-300 words on:
Segregation was the defining social issue when Rosa Parks took her historic stand. Select a social issue that you
think should be addressed today. How will you use the principles of Rosa Parks to address it?
Application - Page 1 of 2
Name:____________________________________
Application - Page 2 of 2
Family (failure to fully disclose will disqualify you):
Name of Parent(s)/Guardian(s):
Address:
Home Phone:
City/State/Zip:
E-Mail:
List each Parent/Guardian’s Place of Employment, Occupation, Job Title:
Number of Brothers/Sisters:
List Ages:
Financial (failure to fully disclose will disqualify you):
Provide Family/Household Income (verification of income may be required):
Below $20,000
$20,000 - $40,000
$40,000 - $60,000
$60,000 - $80,000
Over $80,000
How much have you saved for college: $________________
Describe your financial need for a scholarship (important – be very specific):
Other scholarships you have applied for:
Other scholarships/grants you have already been awarded (name, amount and period of time covered):
If granted this award, how do you plan to pay for the rest of your educational costs?
Signatures:
Applicant:
Parent/Guardian:
Date:
Date:
In addition to a completed application form, the following items must be included before your application can be
considered (check boxes below to indicate items are included):
Three (3) Recommendation Letters (one must be from school staff member)
High School Transcript (official copy)
ACT or SAT Test Results (official copy, or as part of high school transcript)
ESSAY - a statement of 200-300 words
Mail COMPLETE package only, postmarked by March 1, to:
Rosa Parks Scholarships
P.O. Box 950
Detroit, MI 48231
Incomplete or late applications will NOT be considered!
Judging results will be e-mailed to applicants. Winners will be listed on web site (mid-May).
This portion of the application will not be used for judging purposes - it will be separated from
the application upon receipt, and used only if you are awarded a scholarship.
Dear Rosa Parks Scholarship Applicant:
Each year, The Detroit News publishes an article featuring all of the students who have been awarded
scholarships. Please complete the following, so that we will have the information necessary to prepare the article.
Do not say “see attached”, because this is detached from the application, so there will be no attachment to see.
PLEASE complete.
Name:
High School:
Home Town:
College:
Major:
Career Plans:
Name of Parents or Guardians
Phone:
Achievements (please list 3 to 5 achievements, in order of importance to you).
Some Examples: National Honor Society, Vice-President of Student Council, Class President, Class Salutatorian, U of M Youth
Orchestra, National Merit Commendation, Eagle Scout, Long Jump State Champion, Volleyball All-Regional, YWCA Woman of
Achievement, Karmanos Cancer Institute Apprentice, Yearbook Editor, School Volunteer of the Year, etc.
Thank you.
PHOTOGRAPH
Attach your photograph here (one
your parents
would be proud to see in the newspaper)
A good COLOR close-up
No printer generated,
or photos using a copy machine.
Photo will not be returned.