Phil Greiner Memorial Scholarship

MARY F. PETTIT MEMORIAL SCHOLARSHIP

Mary Pettit, educator, community servant, loving mother and grandmother passed away in April of 2004. Mrs. Pettit was a teacher at Fairfield High School for 28 years, earning numerous awards as Teacher of the Year and other distinguished educator honors. She also served as a representative and judge for various speech and journalism associations. She left our mortal world, but her legacy continues at Fairfield Community High School and especially through the Mary F. Pettit Memorial Scholarship.

Each year, a $500.00 scholarship will be awarded to a senior who is academically strong, involved in extra curricular activities, and demonstrates financial need to acquire post high school education.

You must be a graduate of Fairfield High School to be eligible for this scholarship. APPLICATION FOR THE MARY F. PETTIT MEMORIAL SCHOLARSHIP

Criteria: 1.) Academically Strong, 2.) Involved in extra curricular activities, 3.) Financial need

This award of $500 is to be applied toward the award winner's expenses at the college, university, community college of his/her choice. Application deadline is April 1, 2011 Please return completed application to the guidance office.

Please fill out the requested information as completely and accurately as possible. Type or print legibly.

Name in full: ______Birth Date: ______Home address: ______Telephone: ______Name of parents or guardians: ______Address: ______Telephone:______Father's occupation: ______Mother's occupation: ______***************************************************************************** HIGH SCHOOL RECORD: G.P.A.:______CLASS RANK: ______OF______(Attach high school transcript including test scores and rank)

How many years have you attended Fairfield Community High School: Grade(s) 9 10 11 12 (circle)

****************************************************************************** Complete the following page using 1 ,2, 3, and 4 to represent grades 9, 10, 11, 12 respectively. Example: Band (1, 2, 3, 4) means participation all four years, and Student Council (2, 3) means participation in grades 10 and 11.

List high school activities in which you have participated and any offices held. ______

List any special honors or recognition which you have received. ______List church, community or other club activities in which you have participated, and the offices held, if any. ______

List any other scholarships or awards you have applied for:(In lieu of a large list, just write "many local scholarships") ______

List any scholarships or awards you have already received and the amount of each: ______

FUTURE PLANS:

What college do you plan to attend? Please include address. ______

Please write a paragraph telling of your career interests. ______

Any other statement you would like to make to help the selection committee better understand your situation as to why you feel you should be considered for this award.

______FINANCIAL NEED ASSESSMENT:

As financial need is one of the criteria for the Mary F. Pettit Scholarship, the following information is required for consideration. All information will be held in strict confidence. I hereby certify the information is correct:

Student______Parent______

1.) Number of persons living in your household including applicant. ______2.) Number of college students in household next fall including applicant. ______****************************************************************************** FINANCIAL ANALYSIS: Father’s Stepfather’s Annual Income______Mother’s Stepmother’s Annual Income______Amount of other taxable income of parents: ______Total: ______****************************************************************************** Positions of gainful employment held by student: ______when______when______when______Present job______RECOMMENDATIONS:

Please obtain the signatures of three people who would recommend you for this award. (May be educators, pastors, community leaders, etc.)

______Phone______Attach

______Phone______Picture

______Phone______Here