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Undergraduate Scholarship Application

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Undergraduate Scholarship Application ILLINOIS LEGISLATIVE BLACK CAUCUS FOUNDATION 2017 - Undergraduate Scholarship Application ILBC Board Members Scholarship Eligibility: JOINT CAUCUS CHAIRMAN This application is for students seeking an undergraduate degree. Applicants SEN. KIMBERLY A. LIGHTFORD should be an accepted student at an accredited institution of higher learning to SENATE BLACK CAUCUS CHAIRMAN include community colleges, private institutions and certified vocational training SEN. TOI HUTCHINSON programs. HOUSE BLACK CAUCUS CHAIRMAN REP. CAMILLE LILLY ILBC Members, ILBC employees, ILBC Foundation board members, and their ILBC TREASURER immediate relatives are ineligible for the scholarship program. REP. ELGIE SIMS ILBC SECRETARY How to Apply: REP. LITESA WALLACE You can email the Illinois Legislative Black Caucus Foundation Scholarship ILBC SGT. AT Selection Committee at [email protected] to request an application. ARMS/PARLIMENTARIAN REP. SONYA HARPER All applicants must: CAUCUS MEMBERS Be an Illinois resident REP. CAROL AMMONS Complete the ILBCF Undergraduate Scholarship Application SEN. JAMES CLAYBORNE JR. SEN. JACQUELINE Y. COLLINS Submit verification of college enrollment or letter of acceptance REP. MONIQUE DAVIS Write a personal statement (500 words or less) describing interest and REP. WILL DAVIS REP. MELISSA CONYEARS-ERVIN involvement in community and public service, hobbies, talents, sports and/or REP. MARCUS EVANS school activities. The statement should address future academic and REP. MARY FLOWERS REP. LASHAWN FORD professional career plans and may highlight any personal challenge(s) REP. LATOYA GREENWOOD perspective has overcome REP. JEHAN GORDON-BOOTH SEN. NAPOLEON HARRIS III Submit high school transcript (if in college, current transcript) SEN. MATTIE HUNTER SEN. TOI HUTCHINSON Submit two letters of recommendation from persons other than relatives SEN. EMIL JONES Submit a recent photograph of himself/herself REP. THADDEUS JONES REP. CHRISTIAN MITCHELL Provide proof of voter registration if 18 years of age or older SEN. KWAME RAOUL Forward the application and all supporting materials to the ILBCF REP. AL RILEY REP. ANDRE THAPEDI Scholarship Selection Committee by May 9th, 2017 (No Exceptions) SEN. DONNE TROTTER Any supporting material not submitted along with application will result in REP. ART TURNER SEN. PATRICIA VAN PELT applicant being disqualified. REP. CHRIS WELCH Application Deadline: All applications for the scholarship must be postmarked by May 9th, 2017. Please take note that only applicants chosen to receive an award will be notified by letter. Submit Applications to: Illinois Legislative Black Caucus Scholarship Foundation Selection Committee P.O. Box 10243, Springfield, IL 62791 ILLINOIS LEGISLATIVE BLACK CAUCUS FOUNDATION 2017 - Undergraduate Scholarship Application Please print and complete form in detail filling in all appropriate blanks, be as specific as possible. Current State Senator _________________________________________________________________________ Current State Representative ___________________________________________________________________ PERSONAL DATA: Full Name _________________________________________________________________Male___ Female___ Permanent Street Address _____________________________________________________________________ City ____________________________________ State_____________________ Zip _____________________ Telephone Number _______________________________Emergency Number __________________________ Date of Birth (Month/Day/Year) ______________Place of Birth______________ Age ____________________ Email Address________________________________________________________________________________ Father's Name (if applicable) _________________ Occupation _______________________________________ Mother's Name (if applicable) _________________Occupation _______________________________________ Please tell us how you learned about the ILBC Scholarship_____________________________________________ EDUCATION: __________________________________________________________________Did you graduate? __Yes ___No Name of High School Address _________________________________________________________________ __Fresh ___Soph ___Jr ___Sr Name of College Address __________________________________________________________________Status? ____________________ Vocational/Trade Address Official Classification (circle one) Pre-Apprentice Apprentice Other___________________ 2. List the school you will attend or are attending: _________________________________________________ School Location (Applicant must submit proof of admission to an accredited college, university, or trade.) 3. List your area of study ______________________________________________________________________ 4. Personal Statement (Separate Sheet 500 words or less) describing interest and involvement in community and public service. CERTIFICATION: I hereby certify that all information in this application is true and accurate. ________________________________ _________________________________ Applicant Name (print) Date Applicant Signature Date .
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