renewal by gegouzhen12

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									                                                  RENEWAL APPLICATION

HISTORY:

The Leo Adler Foundation was established November 2, 1993, on the death of the donor, Leo Adler. Its purpose is to provide awards
for continuing education to qualified applicants.

ELIGIBILITY:

The Foundation will consider applications from Baker County and Powder Valley students who meet all 5 of the following criteria:

      1.   At the time of completion of their high school studies, have or will have met one of the following criteria:
                  a. Graduated from a high school located in Baker County, Oregon; or
                  b. Graduated from Powder Valley High School; or
                  c. Hold a Baker County GED or Union Baker ESD high school completion diploma. GED recipients
                       will not be awarded a scholarship unless they can document substantial educational and other ties to
                       Baker County or Powder Valley educational institutions prior to application; and
      2    Will be enrolled and complete a minimum of 12 credit hours per term or semester and will be working toward a
           degree or an academic award or certificate at an accredited college, university, technical or vocational school.
           (Should the applicant wish to attend a non-accredited school, the applicant may experience delays in an award. It
           will be the responsibility of the applicant to demonstrate the legitimacy of any non-accredited institution); and
      3    Have achieved a cumulative high school GPA of 2.0 or better or have achieved a cumulative collegiate GPA of
           2.0 or better; and
      4.   Have need for financial assistance in obtaining further education; and
      5.   Have good moral character and have demonstrated good citizenship and respect for the law.

Students will be eligible for educational assistance for a total of 15 terms or 10 semesters if their academic and citizenship records
warrant.

HOW TO APPLY:

First Time and Renewal application forms are available online at www.leoadler.com or by written request to the Leo Adler Trust, P.O.
Box 7928, Boise, ID 83707. Once a student has been granted a Leo Adler Scholarship, that student is required to submit a Renewal
Application Packet for additional awards. Application Packets must be postmarked on or before April 1 to the Leo Adler
Foundation, P.O. Box 7928, Boise, ID 83707.

ADDITIONAL INFORMATION:

In addition to a completed application form, other required Renewal Application Packet documents include an academic transcript and
a copy of pages 1 and 2 of the most recently filed Federal Tax Return of the applicant and if claimed as a dependent on another’s tax
return, a copy of pages 1 and 2 of their most recently filed Federal Tax Return, and a brief narrative of your accomplishments to date
and future goals. (Limit to 200 words). Letters of recommendation are optional for renewal applicants.

CONDITIONS OF THE LEO ADLER SCHOLARSHIP REQUIRE RECIPIENTS TO:
Maintain good citizenship and compliance with Federal and State law; send a transcript following the end of each academic
year; remain enrolled in a full time program at an accredited school and maintain a 2.0 or better GPA. Failure to do so will
result in the denial of the following academic year’s renewal application!

   ENTIRE APPLICATION PACKET MUST BE MAILED TO THE LEO ADLER FOUNDATION, P.O. BOX 7928,                                                  1
                 BOISE, ID 83707 AND BE POSTMARKED NO LATER THAN APRIL 1ST
                     HAND DELIVERED APPLICATIONS WILL NOT BE ACCEPTED
                  LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED
                                                     LEO ADLER SCHOLARSHIP
                                                      RENEWAL APPLICATION


                                                 PERSONAL INFORMATION

Name:                                                             E-Mail Address:

Permanent Address:
                                 Street Address/P.O. Box                     City                  State   Zip Code
Telephone Number:                                                 Social Security #:

School Attending

Major / Area of Study:

Academic standing as of beginning of next year:            FR          SO              JR         SR         GR

Anticipated Graduation Date:

How many credits will you be taking:       ON LINE?                                 ON CAMPUS?

Academic periods you plan to attend: (If term, choose only three. If semester, choose only two. Any summer terms or
semesters MUST be full time.)
       TERMS:              SUMMER               FALL         WINTER             SPRING          SUMMER
       SEMESTERS:          SUMMER               FALL         WINTER             SPRING
       VOCATIONAL:

Most recent cumulative grade point average:
Number of years you have received an Adler Scholarship:
Final high school attended:                                   Year graduated from high school:
Are you receiving other scholarships or other forms of financial aid?   YES                NO
        If so, please itemize:

                               FINANCIAL INFORMATION
  FINANCIAL INFORMATION IS REQUIRED AS ONE OF THE CRITERIA FOR THE SELECTION PROCESS

Do any other persons claim you as a dependent on their income tax?       Yes:               No:

Complete the following estimated budget for the upcoming school year (Total Receipts and Expenses must match):

                                          RECEIPTS                                                     EXPENSES
Available Savings:                                              Tuition:
Anticipated Income (Job?):                                      Estimated Fees:
Funding From Parents:                                           Books:
Scholarships/Grants:                                            Room & Board:
Loans:                                                          Travel Expense:
Adler Scholarship Requested:                                    Misc (Specify):
                                                                Misc (Specify):
                                                                Misc (Specify):
   ENTIRE APPLICATION PACKET MUST BE MAILED TO THE LEO ADLER FOUNDATION, P.O. BOX 7928,                               2
                 BOISE, ID 83707 AND BE POSTMARKED NO LATER THAN APRIL 1ST
                     HAND DELIVERED APPLICATIONS WILL NOT BE ACCEPTED
                  LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED
           TOTAL:                           TOTAL:




ENTIRE APPLICATION PACKET MUST BE MAILED TO THE LEO ADLER FOUNDATION, P.O. BOX 7928,   3
              BOISE, ID 83707 AND BE POSTMARKED NO LATER THAN APRIL 1ST
                  HAND DELIVERED APPLICATIONS WILL NOT BE ACCEPTED
               LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED
                                                      LEO ADLER SCHOLARSHIP
                                                        RENEWAL APPLICATION

**APPLICATIONS ARE CONSIDERED COMPLETE ONLY IF ALL APPLICATION MATERIALS ARE
SUMITTED AS ONE ENTIRE PACKET!

COMPLETED PACKET CHECKLIST IS AS FOLLOWS:

        Completed application form. (2 pages)
        A copy of your entire post secondary academic transcripts.
        A copy of pages 1 and 2 of the most recently filed Federal Tax Return of the applicant and if claimed as a dependent of
        another’s tax return, a copy of pages 1 and 2 of their most recently filed Federal Tax Return.
        A brief narrative of your accomplishments to date and future goals. (Please limit to 200 words.)
        A copy of your most recent Financial Aid Letter indicating your financial package for the previous school year,
        including scholarships, grants, and student loans.
        Signed Certification below.

CERTIFICATION

I certify that all information provided in this application is true and complete to the best of my knowledge and that I will adhere to the
conditions of the Leo Adler Scholarship. If requested, I agree to give proof of the information on this application. I give permission
for the Leo Adler Committee to contact college officials for additional financial and/or academic information.

Furthermore, I certify that if I have been subject to any formal disciplinary action resulting from social or academic activity or have
been charged with or convicted of any violation of the law other than minor traffic offenses, I have included a letter of explanation.
SINCE YOUR ORIGINAL ADLER APPLICATION, HAVE YOU BEEN CONVICTED OF A VIOLATION OF THE LAW (Other
than minor traffic violations)? YES             NO
IF YES, ATTACH A LETTER OF EXPLANATION.


Signature:                                                                    Date:
(Should the Committee, at its sole discretion, determine that an applicant’s moral character is in question, it reserves the right to
withhold part or the entirety of any award)


PLEASE DO NOT USE ANY STAPLES OR INSERT APPLICATION INTO FOLDERS OR COVERS!




   ENTIRE APPLICATION PACKET MUST BE MAILED TO THE LEO ADLER FOUNDATION, P.O. BOX 7928,                                                   4
                 BOISE, ID 83707 AND BE POSTMARKED NO LATER THAN APRIL 1ST
                     HAND DELIVERED APPLICATIONS WILL NOT BE ACCEPTED
                  LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED

								
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