(Please Type Or Print Legibly Using Dark Ink Or Download At

SCHOLARSHIP APPLICATION (Please type or print legibly using dark ink or download at www.gratiotfoundation.org/scholarship.aspx) SCHOLARSHIPS AVAILABLE. Select all scholarships for which you are applying either by checking the box, highlighting, circling, underlining, etc. Make sure to clearly mark which scholarships you are applying for. Review criteria at the end of this application thoroughly and only select those scholarships for which you qualify. Be sure to attach any required materials.

Janet Cooper Abbott and Richard Abbott Scholarship Ceo Bauer and Ardis (Bauer) Williams Scholarship

Breckenridge FFA Alumni Memorial Scholarship Sue Dilts Memorial Art Scholarship

Eagle Scout Scholarship Farming Family Scholarship

Carson Fraker Memorial Scholarship Anna Frutiger Memorial Scholarship

Athol Gamble Scholarship Harold B. Goodwin Memorial Scholarship

Leo ‘Bud’ and Janet Goodyear Scholarship Gratiot County Fair For Youth Memorial Scholarship Gratiot Physicians Group Scholarship for an Allied Health Gratiot Physicians Group Scholarship for Children of Professions Student Deceased Physicians Gratiot Physicians Group Scholarship for a Medical Student Gratiot VFW Post 7805 Scholarship

Loren Humm Memorial Sugar Beet Grower’s Scholarship Linn P. Kanitz Memorial Scholarship

Robert W. MacDonald Memorial Scholarship Clyde and Maude Mizer Memorial Scholarship

Katherine Mullinax Memorial Scholarship Ryan Owens Memorial Scholarship

Don and Irene Pavlik Memorial Scholarship Richard D. Prestage Memorial Scholarship

Loren and Becky Roslund Scholarship Richard Thomas Van Haften Family Scholarship

Dale and Camille Weburg Scholarship Youth Advisory Council Scholarship

Mildred Portner Chaffin Scholarship

APPLICANT INFORMATION.

Name: Circle One: Mr./Miss/Mrs. Address: Circle One: Male Female City/State/Zip: County of Residence: Home Phone: Work Phone: Parents: Marital Status (M/D/S ): Address (if different than above):

City/State/Zip: Email:

HIGH SCHOOL INFORMATION. Include a copy of CUMULATIVE high school/college transcript.

High School: Graduation Date: Cumulative GPA: ACT Score: SAT Score: Honors Event Date: Area Skills/Vo-Tech/Career Center Program (if any): Program: Years Attended: COLLEGE/UNIVERSITY INFORMATION. List colleges, in order of preference, to which you have applied. 1. Accepted _____ Application Pending _____ 2. Accepted _____ Application Pending _____ 3. Accepted _____ Application Pending _____ Area of Study: Current Post-Secondary Education (if any): Dual Enrollment Full Time Part Time Name of Institution: Years Attended:

SCHOOL AND COMMUNITY ACTIVITIES. Using only the space below, list extracurricular, community and religious activities in which you have participated during the last four years. List service activities first, then other activities. Leadership Positions, Awards and Activity Year(s) Recognition Example: Student Council 9th-12th Grade Treasurer

ACADEMIC HONORS. Using only the space below, list academic honors you received during high school/college. Honor or Award Year(s) Received th Example: English Award 10 Grade

APPLICANT WORK HISTORY. Using only the space below, list your paid work experience beginning with your most recent position. Dates of Hours per Employer Nature of Work Employment Week

NARRATIVE. Using only the space below, explain why you should be selected to receive a scholarship. Include any potential barriers in continuing your education TO COMPLETE YOUR APPLICATION. The following items must be included or your application may not be considered : 1. Cumulative high school (or college if applicable) transcript reflecting a cumulative GPA. 2. Copy of the Student Aid Report (SAR) only providing the calculated Expected Family Contribution (EFC) from the Free Application for Federal Student Aid-www.fafsa.ed.gov. 3. Other information as listed in the scholarship criteria section at the end of this form for each scholarship for which you are applying. 4. One hard copy of the application must be signed and received or postmarked on or before March 22, 2015, in order to be considered, no exceptions. Faxed applications are not accepted. Scholarship recipients are expected to attend the Foundation’s awards event on May 17, 2015. Details will be provided with award announcements. Return application to: Gratiot County Community Foundation P.O. Box 248 (P.O. Box Must be Included in Mailing) 168 East Center Street Ithaca, MI 48847 For more information, call: (989)875-4222 or E-Mail [email protected]

CERTIFICATION. I acknowledge the information provided in and attached to this application is accurate. In the event I do not pursue the educational opportunity for which I am applying or I receive other financial assistance which covers in its entirety tuition, room and board, and class material expenses, I will relinquish any scholarship awarded so those funds may support another student’s pursuits.

Signature of Applicant: Date:

SCHOLARSHIP CRITERIA (Applicants must review this information thoroughly and be certain to attach any additional documentation required.) COUNTY-WIDE SCHOLARSHIPS  Must use scholarship in the pursuit of post- Sue Dilts Memorial Art Scholarship secondary vocational, technical, or undergraduate  Must attend or be a graduating senior of a school in education; Gratiot County;  Must demonstrate high moral character and  Must pursue education beyond the classroom in arts participate in service to the community; (e.g., band camp, dance workshops art class, etc.).  Must submit personal letters of reference from the One scholarship available for as much as $800. Scout Leader and one other individual representing community, school or church; Mildred Portner Chaffin Scholarship  Must submit a completed Eagle Scout Scholarship  Must be a Gratiot County high school junior or Information Form available on the Foundation’s senior; website or by calling the Foundation at (989)875-  Must use scholarship in pursuit of a post- 4222; and secondary education at a college or university or  Must submit a completed Gratiot County in a vocational or technical program; Community Foundation Scholarship Application  Must complete and submit the Foundation’s available on the Foundation’s website or by calling Scholarship Application; the Foundation at (989)875-4222.  Must complete and submit an historical essay One scholarship for as much as $500. focused on a person, place or event in Gratiot County. The essay must: Farming Family Scholarship Be typewritten and double-spaced in a  Must be a graduating senior from a Gratiot County o high school pursuing a post-secondary degree in 12 point font size with one inch margins agriculture or agriculture-related fields at a college, all around; university, vocational or trade school o Include a title page, annotated  Previous recipients may reapply with no priority bibliography and the body of the paper preference; be no more three 8.5 x 11 inch pages in  First preference given to students with a farm family length; background; o Not be bound in any way other than a  Academic excellence; paper-clip;  Demonstration of high moral character; o Utilize at least one original source  Evidence of service to community; and identified in an annotated bibliography;  Completed essay on the applicant’s farm family o Follow current and generally accepted background and its impact on who you are and what you wish to become. rules for writing an historical essay. One scholarships available for as much as $1000.  Students are encouraged to use the Gratiot County Historical and Genealogical Society, Anna Frutiger Memorial Scholarship and/or other local historical and genealogical  Must be a graduate student pursuing a doctoral societies, as a resource in writing the historical degree in medicine or dentistry at an accredited US essay; medical or dental school;  Essays will be archived at the Gratiot County  Must be a graduate of a Gratiot County high school Historical and Genealogical Society as a with preference to Alma High School graduates;  Must demonstrate financial need, academic resource for future research. excellence and high moral character; One scholarship available for as much as $500.  Must provide evidence of service to community;  Must submit essay on goals as a medical/dental Eagle Scout Scholarship professional;  Must be an Eagle Scout currently registered in an  Must provide personal letter of reference from active unit in Gratiot County, Michigan OR maintain academic advisor, clergy member or other nonfamily the BSA “College Reserve” registration; member attesting to community service and high  Previous recipients may reapply, but will only be moral character. considered if there are no new applicants; One scholarship available for as much as $2,700.  Must have earned their Eagle Scout Award while a member of a Gratiot County Boy Scouts of America Troop; Gratiot County Fair For Youth Memorial  Must have been a member of a Gratiot County Boy Scholarship Scouts of America Troop for at least two years;  Must be a graduating high school senior accepted at  Must be a legal resident of Gratiot County, unless a a college, university or trade school OR a student graduate student who meets other requirements; currently in his or her first year at a college, university or trade school; Gratiot VFW Post 7805 Scholarship  Must be a current Gratiot County Fair for Youth  Must be a graduating senior of a school in Gratiot exhibitor who has participated for a minimum of County seeking post-secondary education; five years with a preference to exhibitors who  Must submit a one-page, typewritten essay participate in multiple areas; answering the question, “What does military service  Display a commitment to community service; mean for the nation?”;  Demonstrate leadership skills;  Preference to relatives of veterans-attach list of veterans, their service and relation to applicant;  Must not be a previous recipient of this scholarship;  Preference to those demonstrating academic  Must submit an essay outlining the skills learned as achievement and financial need. a fair exhibitor and how those skills will serve you One scholarship available for as much as $1,300. throughout your lifetime. Be certain to address the aforementioned criteria. Essays must be no longer Loren Humm Memorial Sugar Beet Grower’s than one typewritten page in an easy to read font. Scholarship Also include at least one personal letter of reference.  First preference to seniors graduating from a Gratiot Two scholarships available for as much as $550 each. County high school. If none, then previous graduates from a Gratiot County high school may be Gratiot Physicians Group Scholarship for an Allied considered; Health Professions Student  Must be from a family of sugar beet growers, have  Must be a Gratiot County resident; executed a 4-H project related to sugar beets, or be  Must demonstrate commitment to serving the from a family that owns sugar shares as documented Gratiot service area following completion of by at least one letter of reference from a 4-H education; Advisor, FFA Advisor, and/or a field man;  Must be enrolled in post-secondary education  Must have a 3.0 grade point average based on a 4.0 pursuing a degree in an allied health profession; scale;  Demonstrated academic achievement and financial  First preference to applicants pursuing a degree at a need; college or university. If none, then applicants  Previous recipients may reapply for up to three years enrolled in trade or vocational programs may be with preference given over new applicants. considered; One Scholarship for as much as $500.  Financial need is a consideration for this scholarship, but not a requirement; Gratiot Physicians Group Scholarship for Children  Whether an applicant is pursuing a career in of Deceased Physicians agriculture or ag-related business is a consideration  Must be a Gratiot County resident and child of for this scholarship, but not a requirement; and deceased physician;  If sugar beets cease to be grown locally or there are  Must be enrolled in post-secondary education in any no applicants with family or 4-H connections to area of study; sugar beet growing as referenced above, the  Demonstrated academic achievement and financial scholarship may be awarded to other crop growers need; meeting like criteria.  Previous recipients may reapply for up to three years One scholarship available for as much as $500. with preference given over new applicants. One Scholarship for as much as $500. Linn P. Kanitz Memorial Scholarship  Must be a student at a school in Gratiot County; Gratiot Physicians Group Scholarship for a Medical  Must apply scholarship to band camp tuition; Student One scholarship available for as much as $500.  Must be Gratiot County resident and enrolled in medical school; Robert W. MacDonald Memorial Scholarship  Must demonstrate commitment to serving the  Must be a graduating senior of a school in Gratiot Gratiot service area following completion of County or Alma College student; education;  Must pursue post-secondary study in journalism;  Demonstrated academic achievement and financial  Must submit two references on a form specific to need; this scholarship (form available from high school counselor or Foundation Website). One must be  Preference to students attending Central Michigan from minister, church youth advisor or adult with University College of Medicine; first-hand knowledge of personal qualities and moral  Previous recipients may reapply for up to three years character and the other from a teacher or counselor; with preference given over new applicants.  Must submit a one page, typewritten essay outlining One Scholarship for as much as $500. your career and educational goals and why citizenship, community service, church involvement  Must be a graduating senior of a school in Gratiot and moral character are important to you. County pursuing post-secondary education; Two scholarships available for as much as $2,150 each.  Must be a member of YAC for at least two years and have participated in no less than five meetings Katherine Mullinax Memorial Scholarship and/or YAC community service activities each year;  Must reside in Gratiot County and be either a  Must have at least a 3.0 GPA on a 4.0 scale; graduating high school senior OR full-time student  Must submit confirmation of service from YAC enrolled in post-secondary educational institution Advisor; including college, university, vocational and post-  Must submit a one-page, typewritten essay graduate study OR previous scholarship recipient; illustrating the impact of YAC on applicant’s life  Preference given to those demonstrating academic AND applicant’s community; achievement, community service and financial need.  Must submit at least one and no more than three As many as 9 scholarships available for as much as letters of support of` applicant’s community service $2,000 each. and moral character (family members and YAC advisors excluded). Don and Irene Pavlik Memorial Scholarship One scholarship available for as much as $200.  Must be a graduating senior from Breckenridge, Alma or St. Louis High Schools and pursuing post- secondary education at an accredited college, ALMA HIGH SCHOOL SCHOLARSHIPS university or trade school; Alma Schools Athletic Hall of Fame Scholarship  Preference given to those pursuing a degree in the See high school counselor for more information. field of education. Ryan Owens Memorial Scholarship One scholarship available for as much as $1,100.  Must be a graduating senior of Alma High School;  Must pursue post-secondary education in auto Richard D. Prestage Memorial Scholarship mechanics or agriculture at a trade school,  Must reside or be employed in Gratiot County; vocational program, college or university;  Must pursue education in the field of nursing;  Must have at least a 2.0 GPA on a 4.0 scale.  Prior recipients may apply. Two scholarships available for as much as $1,800 each. Two scholarships available for as much as $1,200 each.

Loren and Becky Roslund Scholarship  Must be a graduating senior of a Gratiot County high BRECKENRIDGE HIGH SCHOOL SCHOLARSHIPS school pursuing post-secondary education at a Breckenridge FFA Alumni Memorial Scholarship college, university or vocational/trade school;  Must be a current or past Breckenridge FFA  Previous recipients may reapply without preference; member;  Must have a minimum 2.5 GPA on 4.0 scale;  Must be in pursuit of a post-secondary degree at a  Preference to students pursuing a career in college, university, vocational or trade school; agriculture, engineering, computer-aided drafting or  Must have at least a 3.0 GPA on a 4.0 scale; similar area;  Previous recipients may reapply;  Must demonstrate financial need;  First preference will be given to a graduating senior  Must provide a personal letter of reference from a and those demonstrating high moral character,and non-family member (such as clergy, teacher or those presenting evidence of service to school and advisor. community One scholarship available for as much as $1,000. One scholarship available for as much as $1000.

Dale and Camille Weburg Scholarship Leo ‘Bud’ and Janet Goodyear Scholarship  Must be a Gratiot County high school graduating  Must be a graduating senior of Breckenridge High senior; School pursuing post-secondary education at a  First preference given to those pursuing a career in college, university or trade school; agriculture or agriculture-related fields;  Must have at least a 3.0 GPA on a 4.0 scale;  Demonstrated high moral character;  Preference given to those demonstrating financial  Must submit a letter of reference from a teacher, need; advisor, pastor, employer providing examples of  Preference given to those pursuing education in the demonstrated high moral character; and field of agriculture.  Financial need may be considered. Two scholarships available for as much as $1,450 each. One scholarship for as much as $500. Clyde and Maude Mizer Memorial Scholarship Youth Advisory Council Scholarship  Must be a graduating senior of Breckenridge High School pursuing post-secondary education;  Must be a member of Breckenridge FFA;  Must be a graduating senior of Fulton High School;  Consideration will be given to applicant’s proposed  Previous recipient of this scholarship (may reapply course of study, academic performance, character with no preference); and financial need;  Must demonstrate financial need;  Must submit at least one letter of recommendation  Must demonstrate academic achievement; from a member of the Breckenridge FFA Alumni  Must demonstrate service to school, community, and Association. One scholarship available for as much as $1000. home;  High moral character; and Richard Thomas Van Haften Family Scholarship  Submission of a completed application with all  Must be a graduating senior of Breckenridge High necessary attachments on a timely basis. School pursuing post-secondary education at an One scholarship available for as much as $500. accredited college or university;  Must have at least a 3.0 GPA on a 4.0 scale; ITHACA HIGH SCHOOL SCHOLARSHIPS  Consideration will be given to those demonstrating Carson Fraker Memorial Scholarship financial need;  Must be a graduating senior of Ithaca High School  Consideration will be given to the applicant’s pursuing post-secondary education at an accredited service to church, school and community as well as college or university; to demonstrated moral character.  Preference given to those with high academic Two scholarships available for as much as $500 each. achievement and demonstrating financial need. As many as 6 scholarships available for as much as CARSON CITY-CRYSTAL HIGH SCHOOL SCHOLARSHIPS $1,000 each. Ceo Bauer and Ardis (Williams) Bauer Scholarship  Must be graduates of Carson City-Crystal High Harold B. Goodwin Memorial Scholarship School pursuing a post-secondary education at an  Must be a graduating senior of an Ithaca High accredited college or university; School pursuing a post-secondary education at a  Must be between the ages of 16 and 25; college or university, or post-secondary  Preference given to those pursuing an education in underclassman currently enrolled at a college of the field of agriculture or forestry; university pursuing a Pharmacology degree (first  If no applicants pursuing an education in the field of preference but non-exclusive) or a degree in a agriculture or forestry, consideration will be given to qualifying Licensed (Human) Health Profession; demonstrated financial need, career aspirations and  Previous recipients may re-apply without preference; community service;  Must have a minimum 3.0 GPA on a 4.0 scale; No preference given for academic achievement,   Must demonstrate financial need; except in the case of prior recipient applications;  Must provide a personal letter of reference from a  Prior recipients of this scholarship may apply (college transcript required confirming minimum non-family member (such as clergy, teacher or 2.00 GPA over the previous two terms based on a advisor); and 4.00 scale);  Must submit a one page, typewritten essay outlining Two scholarships available for as much as $1,300 each. why you chose this (pharmacology or medical) field of study and what you hope to accomplish. FULTON HIGH SCHOOL SCHOLARSHIPS One scholarship for as much as $600. Janet Cooper Abbott & Richard Abbott Scholarship  Must be a graduating senior of Fulton High School William Kirby Memorial Scholarship or Fulton Alternative High School pursuing post- See high school counselor for more information. secondary education at an accredited college or university; ST. LOUIS HIGH SCHOOL SCHOLARSHIPS  Must have at least a 3.0 GPA on a 4.0 scale; Paul P. Cameron, Jr., Memorial Scholarship  Previous recipients may apply with no preference; See high school counselor for more information.  Preference to those demonstrating financial need and academic achievement; Melba Hagen Hollenbeck Memorial Scholarship and  Consideration given to community service and Jerry Hollenbeck Honorary Scholarship demonstrated moral character; See high school counselor for more information.  Must submit a one-page, typewritten essay outlining future goals and aspirations and completing phrase, “The most important factors in my education to this point have been . . . “ One scholarship available for as much as $1,900.

Athol Gamble Memorial Scholarship Fund