THE GREATER EAST ST. LOUIS COMMUNITY FUND
2012 – 2013 SCHOLARSHIP APPLICATION
Merit Scholar Dr. Garrett Fellowship
High School Seniors College Seniors
APPLICATION DEADLINE – April 16, 2012
NOTE: All Applicants must be residents of East St. Louis or Brooklyn
HOW TO APPLY
1. Submit completed original application to the Greater East St. Louis Community Fund. It
must be typed or printed legible in black ink. Request additional applications if needed. Answer
all questions completely. If a question does not apply to you write N/A (not applicable). Leave
no questions unanswered.
2. Submit two (2) Letters of Recommendations. Recommendation letters are required. At least
one recommendation must be from a teacher or counselor at your school. Reference letter
format is attached.
3. A copy of your Letter of Acceptance from college you plan on attending. Must be
submitted with application.
4. Personal Essay must be enclosed with your application. The essay must be no more than
250 words. Questions are noted on page 4 of the application.
5. A photocopy of your Student Aid Report (SAR) from your University/College must be sent
to the Greater East St. Louis Community Fund office. Your SAR must cover the same
academic year as the application for Award.
6. You must submit a copy of your “2012-2013 Federal Student Aid Report” (FAFSA).
Applications are accepted as of January 1, 2012 until funds are depleted. All Scholarship
Applicants are encouraged to submit their FAFSA immediately. Visit their website at:
www.fafsa.ed.gov for deadlines and instructions.
7. Dependent Students must include parent financial information. If you will not be 24 years
of age by Dec. 31st , 2012, but wish to apply as an independent, you MUST verify that you fit
one of the following criteria:
An orphan or ward of the state
A parent with legal dependents
A married student
8. Official Transcript - All applicants must arrange for an official academic transcript be sent
directly from your high school guidance office to the Greater East St. Louis Community Fund
office. The transcript must show 2011-2012 fall semester grades.
9. Copy of Utility Bill – to verify residency in East St. Louis or Brooklyn. This must be included
with your application.
Documents must be submitted to:
Greater East St. Louis Community Fund
P.O. Box 547
East St. Louis, Illinois 62202
Phone: (618) 271-2200
or electronically at email@example.com
GESTLCF SCHOLARSHIP APPLICATION
1. Last Name: First Name: Middle:
2. Permanent Address: City: State: Zip:
3. Home Phone: Cell Phone: Sex: M F Age: DOB:
4. U.S. Citizen: Yes or No
5. Personal E-Mail:
6. Employer: Job Title: Phone:
7. Father: Job Title: Employer:
8. Mother: Job Title: Employer:
9. Legal Guardian: Job Title: Employer:
Describe any special circumstances in your home or family that affect your educational
goals. This may include physical conditions, disability, or family instability. Use
10. Living arrangement during coming academic year:
Parents Own Home Dorm Apartment Relatives
11. College you plan to attend in fall 2012. If undecided, list your top two choices to which you
have applied. Note: You will have to submit a copy of your acceptance letter before final
scholarship consideration is given.
12. Name of School City & State Accepted
Yes or No
Yes or No
APPLICANT’S EDUCATIONAL INFORMATION
13. Student Classification in the Fall 2012: (check one)
Freshman Sophomore Junior Senior
1 year Graduate 2 year Graduate
14. Total number of hours enrolled for 1st Semester:
1. # of Hours:
15. Major or course of study?
16. Degree you are pursing: Associate Bachelors Masters PhD
17. I am an applicant for financial aid at the college I plan to attend
YES or NO ? If NO, attach a note and explaining why not.
Current and anticipated financial aid resources: Source and Amounts
RESOURCES ANTICIPATED APPROVED or
1. WORK STUDY
2. VETERANS OR SOCIAL SECURITY
4. ILLINOIS MONETARY
5. AWARD PROGRAM
6. PELL GRANT
7. SCHOLARSHIP GRANTS
8. STAFFORD LOAN (GSL)
9. PERKINS LOAN (NDSL)
10. OTHER (describe source)
TOTAL $ $
18. Where did you learn about this scholarship?
19. List two local persons who are not members of your household who will know your address after you
leave school and are authorized to disclose it to us and give us their e-mail address.
1. Name: Address: City State Zip Phone
2. Name: Address: City State Zip Phone
Personal Essay must be enclosed with your application. The essay must cover each of the
21. Describe your professional and personal goals.
22. Describe circumstances or people that have influenced you or had an effect on your
achievement, and/or unusual hardships you have had to overcome or will overcome to
achieve your goals.
23. Describe volunteer involvement in community service work you have done. Concentrate on
those most important to you, and would you be willing to provide community service in
East St. Louis and/or Brooklyn during the coming years and if so where?
24. Submit two personal letters of reference must be submitted for your application to be
complete. Use the attached reference letter form. These letters must also be submitted by
April 16, 2012.
25. Submit a copy of a current utility bill to verify residency.
26. REQUIRED AUTHORIZATIONS I authorize The Greater East St. Louis Community Fund
and its agents to examine, verify and discuss my academic and/or financial records and other
information which applies to me. I also understand that an unsigned or incomplete application will
make me ineligible for consideration for an award.
Student’s Signature: ______________________ Date: ____________________
27. I certify to The Greater East St. Louis Community Fund that all information here is true and
complete to the best of my knowledge and that I understand that the committee makes the decision
regarding my participation in this program, in reliance upon the truth and correctness of the
information I provide.
Student’s Signature___________________________ Date: ____________________
DEADLINE FOR ALL APPLICATION IS April 16, 2012
SEND ALL INFORMATION TO:
THE GREATER EAST ST. LOUIS COMMUNITY FUND
P. O. Box 547
EAST ST. LOUIS, IL 62202
For questions call (618) 271-2200