Penrose Family Scholarship Application Form

Applicant # ______[OFFICE USE ONLY]

CLEAR SCHOLARSHIP APPLICATION 2013 For Marquette Catholic High School Seniors

Check List: ____ Completed Application ____ Official High School Transcripts

(Your application will NOT be considered if any of the documents are missing)

INSTRUCTIONS Submit this completed application with an official copy of your high school transcripts. (Your application will be considered incomplete if these are not submitted!) Applications must be received by 4 p.m., Monday, April 1, 2013 Return completed form to your high school guidance office, or send to: Community Foundation of Jackson County Phone: 563/652-4179 120 ½ South Main St., Maquoketa, IA 52060 Fax: 563/652-4203 E-mail: [email protected] Web: www.cfofjc.org

NOTE : All sections MUST be completed in order for your application to be considered. Do not leave any section blank. Incomplete applications will be discarded. COVER SHEET APPLICANT DATA

Name ______Last First Middle Address ______Street City State Zip Phone # ______Date of Birth ______

Social Security # ______Email ______

Parents/Guardians ______Phone # ______

Address ______Street City State Zip County ______Township (if applicable) ______

To apply for this scholarship you must attend Marquette Catholic High School and be graduating in 2013.

By signing below you are verifying all information on the application to be accurate and honest.

Signature of Applicant ______Date______

Signature of Parent ______Date______Applicant # ______[OFFICE USE ONLY]

SCHOLARSHIP APPLICATION FORM

I. CHRISTIAN VALUES Name of Parish: ______Have you met core requirements for religious education while at Marquette Catholic Schools? ___ Yes ___ No Please explain in your own words how your Christian values strengthen Marquette Catholic Schools.

II. LEADERSHIP / ACTIVITIES/AWARDS / SERVICE (school, community, church) Please list all extracurricular activities, offices, awards and services using the following categories and indicate years of participation. (Type & limit to this page)

H = High School Student C = Community Member

EXAMPLE: Student Council H – 2 years Class Representative Athletics – Track H – 4 years Team Member Student Newspaper H – 2 years Editor Youth Group Leader C – 6 years Program Coordinator

Activities/Leadership/Awards/Service # of Year(s) Involved Responsibility Applicant # ______[OFFICE USE ONLY]

III. ENTREPRENEUERSHIP in regard to social issues, education and business Please answer each of the following questions in 120 words or less. 1. What can Marquette Catholic Schools do to increase enrollment?

2. How did your volunteer service hours create or inspire meaningful results?

3. Please write about a community member who has taught you valuable lesson(s) outside of the classroom and the impact that person has had on your life.

IV. ACADEMIC ACHIEVEMENT

High School attended ______Graduation date ______(Mo/Yr) High School GPA ______ ACT /  SAT (choose one): ______

Scholarship requested for: Name/Location of School ______ 4 Yr. College  Community College  Voc-Tech  (Other) ______

Anticipated Major ______Expected Graduation Date ______(Mo/Yr) I will be enrolled:  full time  half time or more  less than half time I will live:  on campus  off campus  at home with family

Applicant # ______[OFFICE USE ONLY]

V. PERSONAL QUALITIES AND CHARACTER Describe how your unique circumstances make you an appropriate candidate for this scholarship. This could include more information about your Christian values, leadership and participation, impact in your community and education. This information should explain how you fit the specific criteria for the scholarship. (Please type & limit to this page.)

Please read before submitting your scholarship application. By submitting this application, I certify that the information contained therein is correct to the best of my ability and understand that false information or omission of data may result in denial of my application.