Specify Grade Point Average (GPA) Below

Palm Beach County Council of Teachers of Mathematics Carly Littles, President [email protected]

Applicant: Please complete ALL sections of this application. Use NA if question does not apply. Please type or print neatly.

Eligibility Requirements:  The scholarship will be awarded to one graduating senior in good academic standing.  Must be pursuing a career in mathematics education.

The scholarship amount is $500.00 and is nonrenewable.

Mail complete package to PBCCTM: Gai Williams Scholarship Attention: Debbie Perry, Scholarship Chairperson 1203 N. Seacrest Blvd Boynton Beach, FL 33435

Received by March 14, 2016

I. Personal Student Name Address Telephone Email address Date of Birth Parent/Guardian Name: Relationship: Name: Relationship:

II. Scholarship High School name Anticipated Graduation Date Prospective College/University you plan on attending Major Minor

Specify Grade Point Average (GPA) below.

Cumulative GPA on a 4.0 point scale

PBCCTM Gai Williams Scholarship Application 2016 Palm Beach County Council of Teachers of Mathematics Carly Littles, President [email protected]

Student activities/clubs (Student government, National Honor Society, etc.)

Community Activities (Boys Scouts, church, etc.)

Athletics

List any honors, awards, etc., you have received while in high school.

III. Additional Information Answer the following questions using only the space provided.

What has been your most important extracurricular activity? Specifically, explain how you participated in the activity? How will you use this experience in your future education?

PBCCTM Gai Williams Scholarship Application 2016 Palm Beach County Council of Teachers of Mathematics Carly Littles, President [email protected]

PBCCTM Gai Williams Scholarship Application 2016 Palm Beach County Council of Teachers of Mathematics Carly Littles, President [email protected] Why are you interested in a math education career?

What are your specific career goals after graduation? In five years?

Are any member(s) of your Name immediate family Relationship employed with The School District of Palm Beach Location/School County? Position

Applicant Signature I agree that the application and all attachments may be used for the purposes of evaluation and selection by the PBCCTM scholarship committee.

Applicant Signature Date

PBCCTM Gai Williams Scholarship Application 2016 Palm Beach County Council of Teachers of Mathematics Carly Littles, President [email protected] Parent/Guardian Signature Date

PBCCTM Gai Williams Scholarship Application 2016