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					2009 PNB Scholarship Application

Peoples National Bank has provided financial services to Southern Illinois since 1909. In keeping with the
tradition of community service and commitment to the education of future civic and business leaders, Peoples
National Bank has established an educational scholarship which will assist high school graduates in continuing
his/her education at a university, college, trade or vocational school. Each recipient of the Peoples National
Bank scholarship will receive a $500 scholarship.

Eligibility Criteria
The recipient will be selected on the basis of the following.

   Positive leadership and character exhibited in both academic and extra-curricular school activities.
   Positive leadership and character exhibited in community activities.
   Student must plan to enroll full-time at an accredited two/four-year college, university or trade/vocational
    school. (Proof of enrollment will be required for release of scholarship funds.)
   Eligible applicants shall be a graduating senior of high school within the market area of
    Peoples National Bank.
   Applicants must have maintained a “B” average or better for seven semesters of high school.
   Applicant or a parent/guardian of applicant must be a customer of Peoples National Bank

Selection Process
   The Scholarship Selection Committee of Peoples National Bank will administer the applications and
    selection process for the scholarship.
   Applicants must submit a typed application form and furnish a high school transcript for 3.5 years to
    verify grade point average of “B” average.
   Applicants must submit the application and transcripts to Peoples National Bank, Attn: Human Resources,
    P.O. Box 908, Mount Vernon, IL 62864 by March 1 ,2009
   Scholarship Selection Committee will evaluate the applications and approve the selection of recipients.
   The Scholarship Winner will be announced at the school’s annual Awards Program.

Payment of Scholarship Proceeds
   Student will supply proof of enrollment to college/university or vocational school for the 2009-2010 school
    years.
   Student will provide a copy of the tuition bill and/or itemized bill for book expenses, including required
    electronic materials.
   Scholarship funds will be released directly to the educational institution.
   Scholarship funds are not transferable and will expire August 1, 2010.




                                                       -1-
2009 PNB Scholarship Application

First Name:                        Middle:                             Last Name:

Address:                                                               City/State/Zip:


Home Phone Number:
Social Security Number:

Parent(s)/Guardian(s):


School Information
High School:
Grade Point Average:               Weighted:                           Non-Weighted:
Percentile Ranking in Class:

Bank Information
PNB Account No.:
Name on Account:                   Ownership of Account:               Type of Account:
                                       Joint or    Sole                   Checking      Savings

Post High School Education Plan -- Please list the names of the school(s) you plan to attend.
Two Year College:
4 Year College/University:
Trade/Vocational School:
Course of Study or Major:


I respectfully submit this application to the Selection Committee. I understand anyone listed under
parent/guardian in addition to myself on this application may contact Peoples National Bank regarding the
status of the application of the processing of the scholarship.

                                                         ______________________________
                                                                              Signature of Applicant




                                                  -2-
Student Identification
First Name:                       Middle:                           Last Name:


Please list all involvement in school activities and year in which you participated. Include any
sports, groups, clubs, etc. also, please write below about the leadership skills you have acquired
through your participation in these activities.

      ACTIVITY              9     10     11     12              ACCOMPLISHMENTS




Please write a paragraph on leadership you have attempted to give in these activities. Attach
additional pages if needed.




                                               -3-
Student Identification
First Name:                      Middle:                          Last Name:


Please list your involvements in community activities and the year in which you participated.
Also, please write below about the leadership skills you have acquired through your participation
in these activities.

               ACTIVITY                 YEAR              ACCOMPLISHMENTS




Please write a paragraph on leadership you have attempted to give in these activities. Attach
additional pages if needed.




                                              -4-

				
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