North Carolina FCCLA Scholarship

1 North Carolina FCCLA Scholarship

This scholarship is offered annually to encourage outstanding affiliated NC FCCLA members to pursue a degree in a FACS related field. This scholarship is set up in memory of Dr. Pat Werth, former Sate Adviser. One $1000 scholarship will be awarded annually to be paid for the student at the end of the first year in college. The student must maintain a 2.0 GPA to keep scholarship for the one year period.

WHO IS ELIGIBLE TO APPLY HOW WINNERS ARE COMMITTEE MEMBERS FOR SELECTED SELECTION Current affiliated NC FCCLA Characteristics deemed relative A committee of three NC Member the current year to success in FACS related FCCLA Advisers course of study Be a resident of North Carolina SAT Scores NCFCCLA Adviser Be a senior attending a NC High Outstanding qualities of School leadership in school and community life Meet entrance requirements of Scholastic achievement an NC college or university which offers a degree in a FACS related career Enroll in college or university in Financial Need the fall following receipt of the scholarship Major in FACS related field

INSTRUCTIONS: The application needs to be forwarded to the NC FCCLA State Adviser postmarked by February 1st. Information must be written (print) or keyed into the space provided. Do NOT write on the back or add any additional pages.

SEND WITH APPLICATION:

1 Official copy of high school transcript

3 letters of recommendation (FCCLA Local Adviser, School Administrator or Teacher and one other individual from the community, not a relative)

1 two-page typewritten theme: “The role of FCCLA in my Life”

1 one-page typewritten them: “Why I want to major in a FACS related field”

Copy of the previous year’s W2 form for both parents/guardians 2 NCFCCLA SCHOLARSHIP APPLICATION

PLEASE TYPE

Full Name of Applicant ______

Name of High School ______

School Address ______

Phone Number ______

Home Address ______

Name of Parent/Guardian ______

Date of Birth ______Date of Graduation ______Social Security Number ______

Number of years in FACS Classes ______Number of years as an affiliated FCCLA Member ______

Name of college/university the applicant plans to attend ______

Listing of FCCLA Activities

YEAR BRIEF DESCRIPTION OF ACTIVITIES

List all FCCLA offices you have held

YEAR OFFICE 3 FCCLA awards or special accomplishment

YEAR AWARD OR ACCOMPLISHMENT

Other School Activities, Offices Held or Awards

YEAR BRIEF DESCRIPTION OF ACTIVITIES

List Community Activities

YEAR BRIEF DESCRIPTION OF ACTIVITIES 4 List Employment

EMPLOYMEN POSITION T /DATES

List Academic Information

CLASS RANK/CLASS SIZE NON-WEIGHTED GPA

SAT (VERBAL) SAT (MATH)

STATEMENT FOR FCCLA CHAPTER ADVISER/SCHOOL COUNSELOR

I have examined this application and the information and find the records and information is true, complete and accurate.

______(FCCLA Adviser) (Date) (School Counselor) (Date) 5 STATEMENT FOR STUDENT/PARENT/GUARDIAN

I certify that:

 The information provided is true, complete and accurate.

 I have read and understand the rules governing the scholarship.

 I will abide by the rules governing the scholarship.

 If I fail to fulfill the rules governing the scholarship, I will repay the scholarship on the same terms it was disbursed. Repayment will begin within 60 days following certified notification of non-eligibility of scholarship forfeiture.

 The student will send the college/university transcript within one month following the first academic year to NC FCCLA State Adviser with a cover letter requesting the $1000 payment paid to the student.

SIGNATURES FOR STUDENT/PARENT/GUARDIAN

______(Student) (Date) Parent/Guardian (Date)