Maurice Seltzer Math Science award 11 1 11 by bgHlk45

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									          MAURICE SELTZER SCIENCE AND MATH AWARD

History
Maurice Seltzer was a doctor, author, naturalist, stamp collector, and philanthropist. Among other gifts,
he deeded his house to Girl Scouts – the Jane Seltzer Center. Dr. Seltzer established the Science and
Math Award to recognize girls from Girl Scouts of Eastern Pennsylvania who have broadened their
horizons in the fields of science and math while giving community service. The award amount is $50.

Criteria
     Nominated by a non-related registered Girl Scout, using the attached Nomination Form.
     Be a currently registered Girl Scout in 9th-12th grade.
     Be an active member with Girl Scouts of Eastern Pennsylvania for at least two (2) years.
     Displays commitment to the fields of science and/or math in any of the following areas: Girl
        Scouting, school, or community (includes religious activities)
     Shared her experience with others by some visible means (i.e. displays, demonstrations,
        reports, etc.)
     Provide at least one letter of reference which is written by someone other than the person who
        nominated the girl for the award. Completed reference forms must be mailed directly to the
        council office by the person making the reference.
     Incomplete applications will not be considered.



Selection
The Scholarship Committee will review all applications. Girls’ names, addresses, troop number, and
other identifying information are concealed to ensure anonymity and fairness. Award recipients will be
personally notified and recognized at Girl Scouts of Eastern Pennsylvania’s Achievement Ceremony on
April 22, 2012 at the Pennsylvania Convention Center in Philadelphia.

Application Deadline
Application and reference forms must be received by January 17, 2012 at 5:00 p.m. Applications and
references can be mailed, emailed, or dropped off at any of the Girl Scout Service Centers. Faxes will
not be accepted.

Mailing address: GSEP, 2633 Moravian Avenue, Allentown, PA 18103

Contact: girlawards@gsep.org
                       Maurice Seltzer Math & Science Award


NOMINATION FOR:
Applicant’s Name: _____________________________________________________
Address: ____________________________________________________________
City/State/Zip: _______________________________________________________
Phone: __________________________ E-Mail: _____________________________
Parents’/Guardians’ Names: _____________________________________________
School: ______________________________________________________________
Troop #: ______ Service Unit #: _______ Grade: _____
# Years active in Girl Scouts________

Please answer the following questions and attach them to the application.

1. Nominees plans for post-high school study or training

2. College/university or trade school nominee plans to attend

3. Nominee’s career plans

4. Girl Scout position(s) the nominee has held, or leadership activities conducted, related to science
   and math.

5. Awards/recognitions/honors the nominee has received, related to science and math. Include
   grades in math and/or science classes at the time the awards were received.

6. Council-sponsored programs the nominee has attended, related to science and math

7. List the nominee’s volunteer activities in other organizations (including religious activities, if
   applicable) related to science and math.


NOMINATION BY:
Name: ______________________________________ Phone: ___________________

Address: _____________________________________________________________

City/State/Zip: ________________________________________________________

Email Address: _______________________________________________________

Relationship to Applicant: _______________________________________________

Signature: ____________________________________________________________
REFERENCES
Please list at least one non-related adult who can speak of your character, academic achievements,
and/or your Gold Award project. The completed reference form must be mailed directly to the council
office by the person making the reference. Please make copies of the attached reference form and
give them to the adults who are recommending you for this award.

Reference #1’s Name ________________________________________________________
Email _______________________________________________ Phone ________________




Selection
The Scholarship Committee will review all applications. Girls’ names, addresses, troop number, and
other identifying information are concealed to ensure anonymity and fairness. Award recipients will be
personally notified and recognized at Girl Scouts of Eastern Pennsylvania’s Achievement Ceremony on
April 22, 2012 at the Pennsylvania Convention Center in Philadelphia.

Application Deadline
Application and reference forms must be received by January 17, 2012 at 5:00 p.m. Applications and
references can be mailed, emailed, or dropped off at any of the Girl Scout Service Centers. Faxes will
not be accepted.

Mailing address: GSEP, 2633 Moravian Avenue, Allentown, PA 18103

Contact: girlawards@gsep.org
                    Reference Form for Maurice Seltzer Math and Science Award



Applicant’s name:                                                        _________________


Reference’s name:                                                                       _____
Address:
City/State/Zip: ______________________________________________________________
Reference’s email: ___________________________________ Phone: ________________
Reference’s signature: _________________________________________________________


Please answer the following questions and attach them to the reference form. Do not use the name of
the applicant in your answers.

   1. In what capacity do you know the applicant?
   2. How long have you known this applicant?
   3. Describe how the nominee has been involved in the fields of science and/or math.
   4. Why should the nominee receive the Maurice Seltzer Science and Math Award?


Selection
The Scholarship Committee will review all applications. Girls’ names, addresses, troop number, and
other identifying information are concealed to ensure anonymity and fairness. Award recipients will be
personally notified and recognized at Girl Scouts of Eastern Pennsylvania’s Achievement Ceremony on
April 22, 2012 at the Pennsylvania Convention Center in Philadelphia.

Application Deadline
Application and reference forms must be received by January 17, 2012 at 5:00 p.m. Applications and
references can be mailed, emailed, or dropped off at any of the Girl Scout Service Centers. Faxes will
not be accepted.

Mailing address: GSEP, 2633 Moravian Avenue, Allentown, PA 18103

Contact: girlawards@gsep.org
NOMINATION FORM
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