2014 Darlene Jeris Scholarship at Grace Outreach
If you are graduating this June and going to a CUNY Community College, you can qualify for a scholarship
offering you $850 cash!
About the Grace Outreach D. Jeris Scholarship
The scholarship offers you three things:
1. Payments of $400 as you complete the requirements for a 5-week summer prep program and join
first semester activities at a CUNY college.
2. A Grace Outreach college counselor will help you do well in your first year at a CUNY college and
membership in a great peer program.
3. Training this summer (prep program) to improve Math, Reading, and Writing to master the CUNY
Skills CAT/COMPASS Placement Tests at college.
Eligibility
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You must be a GED graduate of Grace Outreach or a high school graduate by June 2014
You must be a female within the age range of 16- 24 and a resident of New York State
You must apply to a CUNY College
Entry Requirements
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Fill out a GO scholarship application
Attend an interview
Participate in the GO Summer Program and a fall college support/study group
(The deadline for the application is June 2, 2014; pick up an application form from Lisa DeMun, Grace
Outreach Office Manager, call 718-328-0580 or e-mail lcalderon@graceoutreachbronx.org to receive
a copy via e-mail.)
Award of your Scholarship
Grace Outreach is awarding a total of $850 in cash to 20 students
 20 hours a week of college prep with a total payment of $400 by the end of the summer (if you
meet the requirements)
 Additional payments when you meet your first semester college goals
 A monthly Metro card for the summer program
2014 Darlene Jeris Scholarship Student Application Form
Grace Outreach College Prep Program
Office Use: Registration Date: _________ First Interview Date________ Second Interview Date________
PART 1: APPLICANT INFORMATION
Deadline for all applications: 6/2/2014
Instructions: This application MUST BE fully completed in INK. Application Essay MUST BE TYPED.
Student Name (Last, First, Middle)
Student’s Date of Birth
_____/_____/______
Marital Status: Please check one
Do you have children? Please check one:
Single
Home Address (Street)
Yes
No
If answer yes to the above questions, what age?
Married
AGE
______
SSN
_____/____/_______
City
Student Home Phone(Include Area Code)
State, Zip Code
Student Cell Phone (Include Area Code)
Name of High School/GED Program
Email Address of Student
Address of School (Street)
Recipient of: Please check one:
City, State, Zip Code
High School Diploma
GED
Year student graduated or Expected date
College Preference: Please check one:
Intended Major
Hostos CC
Bronx Community College
Other_________________________
Ethnicity (Check all that apply):
Alaskan Native
African American
Caribbean
Latina
Middle Eastern
Native American
African
Asian
Caucasian
Other
I affirm that I am the sole author of the attached essay_____________________________________________
Signature of Student
Date
2014 Darlene Jeris Scholarship Student Application Form
Grace Outreach College Prep Program
PART 2: APPLICANT ESSAY
Student applicants are asked to provide a written essay addressing the following question. Answer ONLY
one of the following essays.
A. If we could only admit one more student to the Grace Outreach College Prep Program, why
should it be you?
B. Attach a small photograph of something important to you and explain its significance.
Guidelines for essay:
1. It should be typed using double line-spacing.
2. The font should NOT be fancy: preferable Times Roman or Arial (12) pt.
3. It should not be less than one page and no more than two pages.
4. Please do not put your name on the essay, instead write the four last digits of SS number or your
date of birth.
STEPS: Make sure you follow the steps below to accurately submit the complete application on time:
Step I: Fill out the Application Form
Step 2: Type your essay (make sure you read the directions carefully)
Step 3: Sign and date the Student Contract Form
Step 4: Make sure you enclose all the above in an envelope. You hand deliver or mail to:
Grace Outreach
ATTENTION: Ms. Carol Williams
378 East 151st Street, 5th Floor
Bronx NY 10455
The deadline for the scholarship application to be received by Grace Outreach is June 2, 2014 4:00 PM
2014 Darlene Jeris Scholarship at Grace Outreach
Student’s Contract Form
Please read the following information below, sign, and return with your application form by June 2, 2014.
I hereby affirm that all the above stated information provided by me is true and correct to the best of my
knowledge. I also consent that my picture may be taken and used for any purpose deemed necessary to
promote the organization’s scholarship program.
I hereby understand that if chosen as a scholarship winner, according to Grace Outreach Scholarship
policy, I MUST meet the requirements of the program and adhere to the attendance rule before scholarship
funds can be awarded. I also must be in good academic standing, with a minimum GPA of 2.0, to continue
receiving the stipend. Grace Outreach Scholarship Committee reserves the right to withhold funds
accordingly.
Signature of scholarship applicant: ___________________________
Date: _______________________