Brookdale Community College Foundation

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					                           Brookdale Community College Foundation
                                   Wilbur Ray Scholarship

                AWARD                                       ELIGIBILITY
      One $1000 Annual Scholarship to               Monmouth County resident and
       an incoming Monmouth County                    high school/GED graduates.
       high school graduate to attend                Ethnic Minority Student
       Brookdale Community College                   Completed a Brookdale
      4 $500 Scholarships for a currently            Community College application,
       enrolled Brookdale student                     planning to register as a full-time
      Scholarship is renewable for a                 student in the fall of 2011.
       second year, based on satisfactory            Evidence of Financial Need
       academic record at Brookdale                  Career interest in law enforcement
       Community College.                             and/or related field may have
      Scholarship amount is credited to              preference.
       the student’s account at Brookdale
       to be used to cover tuition, fees or

    Type or print clearly
    Write your name on each attachment
    Application and related documents must be received by Friday
     May 6, 2011
    Attach two (2) letters of Recommendation. (See Part VII)
    Obtain and complete the Financial Aid Form (FAFSA)
    Send application and related documents to:

                     The Wilbur Ray Scholarship Committee
                     Brookdale Community College Foundation
                     765 Newman Springs Road
                     Lincroft, NJ 07738
For Additional Information, email Fax: 732-224-

Check one:

________I am a graduating high school student applying for the $1,000 scholarship

________ I am a currently enrolled Brookdale student applying for the $500 scholarship

I.           Personal Information:

                   (First)              (Middle)                  (Last)


Town:                                   State:                    Zip:


Date of Birth:                                       Ethnicity:
Email Adresss________________________________________

II.          High School Information:

High School: __________________________________ Zip Code: ______________________

Guidance Counselor/Class Advisor: _____________________ Telephone: ________________

      III.      Grades/Transcripts (please include your high school transcript with this

What is your current Grade Point Average, or class standing? ___________________________

      IV.       Extra-Curricular Activities:

List your extra-curricular activities, whether related to school or community. Include any
leadership positions held, awards won, or special recognition achieved.


  V.    Financial Information:

  How do you plan to finance your college education?









  VI.   Essay:

  Please submit a one-page essay (on the last page of this application) describing:

           Your academic program

           Your career objectives

           Why you believe you should be selected for this scholarship

              You financial need

   VII.    Letters of Recommendation:

   Please submit two letters of recommendation:

              One Academic Recommendation (guidance counselor, teacher, class advisor,
               coach, etc.)
              One Community Recommendation (clergy, employer, etc. – not related to you)

   VIII.   Are you currently enrolled for classes at Brookdale Community College?

           Yes ____ No ____

   IX.     Certification/Signature:

I understand

              That the Wilbur Ray Scholarship Committee reserves the right to request
               additional information from any person named herein regarding my eligibility for
               this scholarship:
              That selections for this scholarship will be final;

              That, should I be the recipient and then withdraw from my planned academic
               program, my award will be forfeited.

           I hereby certify that the statements herein are true and that I believe I am eligible for
           this award.

           Signature: __________________________________ Date: ____________________

           ------------------------------INCLUDE YOUR ESSAY--------------------------------------------------


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