2016 Edison Scholarship & Memorial Foundation (ESMF)

2016 Edison Scholarship & Memorial Foundation (ESMF) Application Verification Form

Name: ______ID#: ______

In addition to any ESMF Scholarships, I am also interested in applying for the following scholarships (Please check all that apply):

 Beat the Odds Scholarship (You must do essay question #2 to be eligible for this scholarship.)  Wallin Foundation Scholarships (You must attend a 4-year college in Minnesota, the surrounding area, or a historically black college.)  Page Foundation Scholarships (You must be a student of color.)

I have submitted my ‘Future Plans’ essay, as well as one other essay on one of the following topics:

 Future Plans: Where do you see yourself five and ten years from now? How do your current plans include attending and studying at a post-secondary institution? (Everyone does this one)

AND ONE OF THE FOLLOWING:

 BEAT THE ODDS/Life Challenge: What challenge in your life have you overcome and how has that made you a stronger or better person?  Life's Passion: What is something in your life that you are passionate about (love or enjoy doing) and how might that affect your future career choices?  Learning Experiences: What experience in your life did you learn the most from and what did you learn?

I have asked the following teachers (one of them from a core subject) to write letters of recommendation on my behalf, and I have informed them to turn in their letters directly to Mr. Iacarella:

Name: ______Name: ______

Resume:  I have electronically submitted my Resume (scanned or digital photo)

Authorization for Release of Information

I authorize the Edison Scholarship and Memorial Foundation to release the following information/forms to agencies/individuals who are requesting information for the purpose of awarding scholarships to students of Edison High School:

• Information on my application, copies of my essays and resume.

Updated: 9/22/16 • Financial information (for scholarships that have a financial requirement.) • Copies of Transcripts, High School Test Scores and College Admission Test scores and sub scores.

Signed: ______Date: ______

I understand that a Thank You note for all awards and scholarships is required and that I am required to attend the writing session on the day of the Awards program.

Signed: ______Date: ______

I turned in all the required information (1.Tax information and 2.completed Verification Form) to one of the following:

• Mr. Iacarella, room 331 • Ms. Nora, room 219 • Dr. Hypolite, room 327

Date: ______Time: ______

Signature (of ESMF member): ______

Updated: 9/22/16