Alan-Epstein--Reach-for-the-Stars--Scholarship---2011

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					          12th Annual – 2011 Alan R. Epstein ‘Reach for the Stars’ Scholarship Application
Eligibility:
In order to qualify, applicants must:
      Be a high school senior graduating in June 2011
      Be accepted to a college or university and present a copy of the acceptance letter(s) with this application
      Have application and all attachments postmarked by April 8, 2011
      Submit an Official High School transcript
      Send completed application to Alan R. Epstein “RFTS” Scholarship Fund, c/o The Miami Foundation, 200 S. Biscayne
           Blvd., Suite 505, Miami, Florida 33131-2343.

Please check which category applies to you:
    1. _____ Student of Palmetto Senior High School
    2. _____ A participant of any of the intramural teams at the Boys and Girls Club of Miami
    3. _____ Student of _________________________________________(Senior High School)


Please print clearly in ink, or type:

I.       Personal Information:
Applicant’s full name ____________________________________
Social Security Number: ___________________Date of Birth:____________________
                                                  (month, day, year)
Home Address: ______________________________, _____________________, Florida 33__________.
                   (Street Address)                           (City)
Area Code + Home Telephone # __________________ Fax #______________ Cell#__________________            Email
address_____________________________________

Father's Information (please check ____ if deceased)
Name_____________________________Home Address (if different) ________________________
__________________________________Home Telephone # ____________Work#______________

Mother's Information (please check ____ if deceased)
Name_____________________________Home Address (if different)_________________________
__________________________________Home Telephone #_____________Work #______________

Guardian Information
Name_____________________________Home Address (if different) ________________________
_________________________________ Home Telephone # ______________Work #_____________

Brothers and Sisters
Name                       Age     Educational Background/College Occupation
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

II. High School Information
High School presently attending: _________________________________________I.D.#__________
Telephone # ______ ________________       Fax #_____________________.
High School Graduation Date ______________, 2011. Current GPA (unweighted) _______________.



(ATTACH OFFICIAL HIGH SCHOOL TRANSCRIPT)
Page Two - Alan Epstein "REACH FOR THE STARS" Scholarship


III.     College Acceptance Information – (PLEASE ATTACH LETTER OF ACCEPTANCE TO THIS APPLICATION)

College or university you plan to attend ______________________________.
Intended major____________________________________________



IV.      Teacher/Faculty Recommendation (Do not ask family or friends):

On letterhead stationary, please provide two letters of recommendation from teacher/faculty members who have been involved
in your high school education and from a member of the community whom you have worked with. Please include the nature and
quality of the applicant's academic work, intellectual depth or breadth, character, and personal qualities. (ATTACH
SEPARATELY)

V.       Personal Statement

Directions: On one or two typewritten pages, a font of no less than 12 pts, please prepare your personal statement and career goals.

Discuss circumstances that make you eligible for this scholarship such as obstacles or hardships that you have encountered and
how you have dealt with them paying particular attention to how this negative experience (disability, illness, failure, etc.) has had
a positive impact on your life. (ATTACH SEPARATELY)

VI.      Volunteer/Work Experience and School Activities

On a separate sheet of paper please describe recent volunteer experience, work experience and school activities. Please limit
yourself to one page only.
 (ATTACH SEPARATELY)

VII.     Financial Need

Please provide your family’s estimated combined annual income for the previous year in U.S. Dollars ___________________.
Total number of family dependents: ______________.

Total number of family members who will be attending college at least halftime (6 credits) during upcoming year: ___________.

In one to two paragraphs describe any circumstances related to your family’s financial status which would give the scholarship
committee a better understanding of the importance of the ALAN EPSTEIN ‘REACH FOR THE STARS’ SCHOLARSHIP and what
sets you apart from other applicants. (ATTACH SEPARATELY)
Page Three - Alan Epstein "REACH FOR THE STARS" Scholarship



______I give permission to have my essays published. ______I do not give permission to have my essay published. ______ I give
permission to have my essay published, but wish to keep my name anonymous.




CERTIFICATION:
I HEREBY CERTIFY that the information included in this application is true and accurate to the best of my knowledge.
____________________________________________________________________________________
Signature of Applicant OR Guardian (if Applicant is under the age of 18)       Date



CHECKLIST FOR ALAN EPSTEIN ‘REACH FOR THE STARS’
SCHOLARSHIP APPLICATION:

        Application completed and signed
        High School OFFICIAL TRANSCRIPT
        College Acceptance Letter(s)
        Two letters of Recommendation
        Volunteer/Work Experience and School Activities (ONE PAGE ONLY)
        Personal Statement (NO MORE THAN TWO PAGES)
        One or two paragraphs describing importance of scholarship

				
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