Wild Rose Scholarship Foundation, Inc.
Please indicate the scholarship you are applying for: (One application can be submitted
and meet the requirements to apply for all three scholarships provided you include
the necessary references and required information). If you have questions, please
contact Jamie Koehler at 920-622-4201. ***Incomplete scholarship applications will
not be considered.
______ Martha Jones Scholarship – Graduating Senior
______ Mary Humphrey Scholarship Application - Graduating Senior
______ Mary Humphrey Scholarship Application – Post-Secondary Enrolled
______ Elizabeth C. Davies Scholarship – Post-Secondary Enrolled
______ Wild Rose School District School Forest Scholarship – Post Secondary
All Scholarship Applications are due in the Guidance Office March 1st
Mailing Address __________________________________
Telephone Number____________________ E-mail Address______________________
Name of Parent(s)/Guardians(s)__________________________________________
Present Status (circle one): High School Senior
College Freshman Sophomore Junior Senior
College, University, or Technical College you are attending or plan to attend (or Trade
School for Elizabeth C. Davies Scholarship)
High School Seniors – Have you been accepted? Yes No
Post–Secondary Students - Do you plan to attend the same school this fall? Yes No
If no, please explain your plans___________________________________________
Do you plan on being enrolled both fall and spring semesters? Yes No
GPA__________ (After 7 semesters for graduating seniors) Class Rank _____of_____
GPA___________ Post-Secondary students indicate GPA is based upon _____ semesters
Field (or fields) of Study? Major___________________ Minor____________________
Will you be a full time student? (12 or more semester credits) Yes No
Please indicate from your Federal Student Aid Report (SAR), what your EFC code
is_____________ (the EFC code is found under the first page of the SAR)
Failure to include your EFC code could seriously jeopardize your application for
those scholarships that include financial need as part of the selection criteria. If you
do not provide an EFC Code please attach a statement to explain.
Please attach the following:
1. A list of all co-curricular, extra-curricular, out-of-school, community service,
positions of leadership, and/or community activities in which you have
participated. Please include any special awards, recognition, honors, or
distinctions you have earned. High school applicants please reference activities
during high school and post-secondary applicants please reference activities
2. An official college transcript showing all courses taken and grades earned. Or
provide a high school 7-semester transcript and ACT score.
3. If one or any of the scholarships you are applying for is based upon need, please
explain on an attached sheet why you feel you meet this qualification.
4. Martha Jones Scholarship applicants: Please include a brief statement of your
goals. Also, please include a recommendation from someone in the community
(not a school employee) regarding your character, personality, and work habits.
**Please note that school employees include: teachers, coaches, bus drivers, and
5. Mary Humphrey Scholarship and Elizabeth C. Davies Scholarship
applicants: Please submit one confidential reference. (Form and instructions
available on district website)
6. Wild Rose School District School Forest Scholarship applicants: Please
include a resume detailing any and all field/clinical/in-service/volunteer
experience in your program area. Also, please include a letter of recommendation
from a teacher, supervisor, or professor associated with your program.