scholarship application

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					     MARY E. AND RODERICK F. CONDON II SCHOLARSHIP
Neatness, legibility and completeness of replies will have an influence on the Selection Committee's decision. If a question is
not applicable to your situation, please note "not applicable" in that space. If you need additional space for answers, use extra 8
1/2" by 11" sheets of paper with your name and address on the top right corner. Please type or print in black ink.
STUDENT INFORMATION
Name (First, MI, Last):                                                                                                    Male       Female
                                                                                               Area Code-
Address:
                                                                                             Home Phone:
                                                                                               Area Code-
City:                                            State:        Zip:
                                                                                              Cell Phone:
                                                                                                             Last 4 digits of
Email Address:
                                                                                                             SSN# (required):
High School:

GPA:                         ACT Composite:                SAT Math:                   SAT CR:                       SAT Writing:
College Preference: (Please attach a copy of acceptance letter to this application)
1.                                                                                      University ID (if known):

2.                                                                                      University ID (if known):

Intended College Major:

ACTIVITIES/HONORS-You may list these below or list on a separate sheet and attach to this application.
List school activities in which you have participated (such as clubs, sports, student government, honorary society or special projects).
Include year(s) of involvement and any offices held.




List volunteer community activities in which you have participated (such as church work, community centers).




List any honors or awards that you have received.




WORK EXPERIENCE
List jobs (including summer employment) you have held in the past two years. Include employer, kind of work, dates of employment and
number of hours per week.
Employer:                                   Kind of work:                              Dates of employment:              Hours per week:




FINANCIAL INFORMATION
Have you submitted a Financial Aid Form (FAFSA) and received the Student Aid Report (SAR)?               yes*       no

*If yes, what is the expected family contribution (EFC) as stated on the Student Aid Report (SAR)?

What is your parent’s adjusted gross income (AGI) as stated on the Student Aid Report (SAR)?

We hereby certify that the information set forth in this application is true to the best of our knowledge.

 ____________________________________                     _______________________________________ Date:
Applicant's Signature                                     Parent/Guardian Signature if applicant under age 18


                          DUE DATE: POSTMARKED NO LATER THAN MARCH 25, 2011
SKIP THE SECTION BELOW IF YOU HAVE ATTACHED YOUR STUDENT AID REPORT (SAR) FROM YOUR FAFSA.
PLEASE COMPLETE THE FOLLOWING IF YOU HAVE NOT ATTACHED YOUR STUDENT AID REPORT (SAR).

Please provide the following information for the adults who support the applicant student:

Name:                                                              Relationship:

Employer:                                                          Position:

Name:                                                              Relationship:

Employer:                                                          Position:

TOTAL SIZE OF HOUSEHOLD DURING THE CURRENT YEAR:
(Include parents/guardians, applicant, other dependent children and any other dependents)

NUMBER OF HOUSEHOLD MEMBERS ENROLLED IN COLLEGE:
(half-time or full-time during the coming academic year)

ANNUAL INCOME - PREVIOUS CALENDAR YEAR
                                                                       Student's gross earnings during previous
Parent(s)’ Adjusted Gross Income:
                                                                       calendar year:
                                                                       Student's savings, investments,
Unreimbursed tuition:
                                                                        trust funds:
List recent scholarships and grants - include amounts:




List recent loans - include amounts:




Please describe any special financial circumstances:




Projected annual cost (tuition, room and board) for school you plan to attend:


Attach the following additional information to this application:
                                                                  th
     1. An official high school transcript through the 7 semester.
     2. Letter of recommendation from your current art teacher
     3. A portfolio of six images of works that represent your areas of proficiency: The medium/media used in your
        works (e.g.: acrylic, ink) must be identified. You should also identify the size of the piece and provide a
        title. You must send your images as .jpeg files (300 dpi at 4 inches wide) on a CD or via e-mail to
        ehorner@daytonfoundation.org.
     4. A one page double-spaced essay addressing one of the images you have provided. Explain how you
        created it; include what influenced you to make it and how it expresses your thoughts and feelings.
     5. A copy of the acceptance letter from college/university that includes your Student ID (University ID).

Mail or hand deliver your original application plus three collated copies* to:
                                       THE DAYTON FOUNDATION
                                       Attn: Mary E. Roderick F. Condon II Scholarship
                                       500 Kettering Tower
                                       Dayton, OH 45423

*You only need to include one CD of your portfolio.

                    DUE DATE: POSTMARKED NO LATER THAN MARCH 25, 2011
        MARY E. AND RODERICK F. CONDON II SCHOLARSHIP
The Dayton Foundation is pleased to announce the MARY E. AND RODERICK F. CONDON II SCHOLARSHIP
for the exclusive purpose of assisting individuals to further their studies in the Fine Arts.

A total of $3,000 is available to be awarded in the spring to one current high school senior. The award can be
applied toward tuition and other related educational expenses at an accredited two or four year college/university
or technical school. As part of the scholarship award, recipients will be invited to display works of art as part of a
group exhibition at the Dayton Visual Arts Center, to be held June 17-25, 2010. A closing reception for the artists
will be held on Friday, June 25 from 5 to 7 p.m.
To be eligible for consideration, you must:
       Be a resident of Montgomery County, Ohio
       Pursue a course of study in the Fine Arts including but not limited to drawing, painting, graphic arts,
        ceramics, sculpture, fashion design and set design

       Be accepted as a full-time undergraduate student at an eligible institution
       Submit a completed application form that must be accompanied by:
                                                             th
              An official high school transcript through the 7 semester.
              Letter of recommendation from your current art teacher.
              A portfolio of six images of works that represent your areas of proficiency: The medium/media used
              in your works (e.g.: acrylic, ink) must be identified. You should also identify the size of the piece
              and provide a title. You must send your images as .jpeg files (300 dpi at 4 inches wide) on a CD or
              via e-mail to ehorner@daytonfoundation.org.
              A one page double-spaced essay addressing one of the images you have provided. Explain how you
              created it; include what influenced you to make it and how it expresses your thoughts and feelings.

              A copy of the acceptance letter from college/university that includes your Student ID (University ID)
A Scholarship Selection Committee, appointed by The Dayton Foundation, will review applications. The
Committee may elect not to award a scholarship if, in its sole judgment, an appropriate candidate cannot be
identified. Criteria for selection include: portfolio, art teacher recommendation, essay, participation in school and
community activities, and job history.

Applications are available at your high school guidance office.
Mail or hand deliver your original application plus three collated copies of your application and attachments* by
the due date to:
                                  The Dayton Foundation
                                  Attn: MARY E. And RODERICK F. CONDON II SCHOLARSHIP
                                  500 Kettering Tower
                                  Dayton, OH 45423-1395


Questions? Please contact:
                                  Elizabeth Horner
                                  The Dayton Foundation
                                  937-225-9955 or ehorner@daytonfoundation.org.


* You only need to include one CD of your portfolio.

                DUE DATE: POSTMARKED NO LATER THAN MARCH 25, 2011

				
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