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FAIRVIEW PARK JUNIOR WOMENS CLUB

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					                          FAIRVIEW PARK JUNIOR WOMEN’S CLUB
                               SCHOLARSHIP APPLICATION
                                 SCHOOL YEAR 2009-2010

PLEASE READ THESE INSTRUCTIONS CAREFULLY BEFORE YOU BEGIN:

The Fairview Park Junior Women’s Club is a non-profit group that promotes civic projects, social
welfare, and community improvement. The club was founded in 1954 and is open to all women aged
21 and older. Each year, the club awards one or more college scholarships to a graduating high school
senior who is a resident of Fairview Park. The amounts of these one-time grants vary, depending upon
how much the club raises during the year through its ways and means projects.

We are glad that you are applying for one of the club’s scholarships. Please follow all instructions in
preparing and submitting your application.

1.     You must be a resident of Fairview Park, Ohio, to be eligible for a scholarship from FPJWC.

2.     The FPJWC provides scholarship applications to high school guidance counselors and the
       Fairview Park Regional Library young adult section. Applications are also available for
       download from our website, http://www.FairviewParkJWC.org as a PDF file or Microsoft
       Word document.

3.     Please remember to include all required documentation as described in the application.
       Required documents include: the completed application, HS Transcripts (copy), your Applicant
       Statement, and at least one (1) Letter of Recommendation. Submissions that do not include all
       required documentation will not be considered.

4.     If application used as a Microsoft Word document. Please complete as much of the
       application as possible (except for the signature) on a computer, then print it, sign in the
       appropriate space. Submit the completed application and supporting documents as follows:

       Mail to:

       FPJWC Scholarship Committee Chair
       P. O. Box 26283
       Fairview Park, OH 44126


5.     All applications and supporting materials must be received by the FPJWC no later than April
       XX, 2010. Applications received after that date will not be considered. All decisions of the
       Fairview Park Junior Women’s Club on awards are final and not subject to review.
                           FAIRVIEW PARK JUNIOR WOMEN’S CLUB
                                SCHOLARSHIP APPLICATION

Please follow all instructions as described. Your completed application, with all supporting material,
must be received by or before April XX, 2010 to be eligible for consideration. Thank You.

Part One: Personal Information

Applicant’s Name: ________________________________________________________________
Address: ________________________________________________________________________
Phone: ___________________________________ E-Mail Address: ________________________
High School: _____________________________________________________________________
Names of Parents/Guardian: _________________________________________________________



Colleges:

List all colleges you have applied to. Show your first choice first.

College ________________________________________________________ Accepted ________
College ________________________________________________________ Accepted ________
College ________________________________________________________ Accepted ________



Academic Achievement:

My cumulative grade point average is: ________________________________________________
My class rank is: _______________________________ in a class of ________________________
List any specific honors, awards, or distinctions in academic achievement:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
IMPORTANT: Please provide a copy of your transcript with this application.




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Part Two: Academic and Career Goals

What course of study do you plan to follow in college? (20 words or less)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
At present, what are your professional career goals? (20 words or less)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________


Are there any special challenges you have faced or are presently facing, and which you would like the
committee to consider in reviewing the merits of you application? (50 words or less)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________




Part Three: References

Provide names of three (3) references (not relatives), including one from your school

IMPORTANT: Attach a letter of recommendation from at least one of your references.

Name & Title                              Address and Telephone #
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________



                                                   3
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________



Part Four: Activities

List those extra-curricular activities that you have actively participated in during your high school
career. These can include, for example, service groups, academic clubs, music activities, student
government and leadership, yearbook, newspaper, athletics, special interest clubs, and other activities.
For each, indicate any offices or leadership capacity held, which years you were an active member,
and the approximate number of hours spent each week on the activity.

Activity

Name: ____________________________________________ # of hours per week: ____________
Office Held: _______________________________________ Years of Participation: __________

Name: ____________________________________________ # of hours per week: ____________
Office Held: ______________________________________ Years of Participation: ___________


Name: ____________________________________________ # of hours per week: ____________
Office Held: ______________________________________ Years of Participation: ___________

Name: ____________________________________________ # of hours per week: ____________
Office Held: ______________________________________ Years of Participation: ___________

Name: ____________________________________________ # of hours per week: ____________
Office Held: ______________________________________ Years of Participation: ___________


Name: ____________________________________________ # of hours per week: ____________
Office Held: _____________________________________ Years of Participation: ____________




                                                   4
Community Service and Activities

List your involvement in community activities. For each listing, show the years you were an active
participant, list any achievements, or leadership roles, and state the approximate number of hours spent
each week on the activity. Include Volunteer or Service activities, Church Organizations/Youth
Groups, Scouting, Athletics, etc.


Name: ____________________________________________ # of hours per week: ____________
Office Held: _______________________________________ Years of Participation: __________

Name: ____________________________________________ # of hours per week: ____________
Office Held: _______________________________________ Years of Participation: __________

Name: ____________________________________________ # of hours per week: ____________
Office Held: _______________________________________ Years of Participation: __________

Name: ____________________________________________ # of hours per week: ____________
Office Held: ______________________________________ Years of Participation: ___________


Tell us how these activities have affected you: __________________________________________
________________________________________________________________________________
________________________________________________________________________________



Part Five: Financial Information
Employment

List your most recent jobs first. For each job, identify the employer, and address. State the position
held, dates worked, and hours worked per week.

Employer _______________________________________________________________________
Address_________________________________________________________________________
Position Held ____________________________________________________________________
Hours worked per week ____________________________________________________________
Dates ___________________________________________________________________________




                                                   5
Employer _______________________________________________________________________
Address_________________________________________________________________________
Position Held ____________________________________________________________________
Hours worked per week ____________________________________________________________
Dates ___________________________________________________________________________




Family and Financial Information

Father Occupation: ________________________________________________________________
Mothers Occupation: ______________________________________________________________
Parents Combined Annual Income: ___________________________________________________
Brothers and sisters presently at home or in college
Name and Age                                           School Attending
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Provide estimates of your income and anticipated expenses for your FIRST YEAROF COLLEGE:


                Income for College                          Anticipated College Expenses
Savings for College:        $                     Tuition & Fees:               $
Family Assistance:          $                     Room & Board:                 $
Gifts:                      $                     Books:                        $
Other Scholarships/Grants $                       Transportation:               $
Student Loans:              $                     Other Expenses*:              $
Other*:                     $
                                                  TOTAL:                      $
TOTAL:                      $

*List other income/expenses on a separate sheet



Part Six: Applicant’s Statement
Please attach a written statement (250 words or less) explaining why you should receive this award.
Describe your future goals and how you are committed to achieving them.




                                                   6
Sign Below and return this page with your application*.

I certify that I am submitting this application in good faith and that all statements made in this
application and the supporting materials prepared by me are true, complete, and correct to the best of
my knowledge and belief and are made in good faith.


Applicant’s Signature: __________________________________________________
Date: _________________________________________________________________



*Please remember to include all required documentation as described in the application. Required documents include: the completed
application, HS Transcripts (copy), your Applicant Statement, and at least one (1) Letter of Recommendation. Submissions that do not
include all required documentation will not be considered.


Please start a new page for your Applicant’s Statement




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