KIBBLE FOUNDATION SCHOLARSHIP APPLICATION APPLICATION DEADLINE FOR FILING: MAY 15

NAME OF COLLEGE: ______CHECK ONE: Initial Application ______Renewal______BE SURE YOU QUALIFY BEFORE YOU FILE THIS APPLICATION. READ APPLICANT QUALIFICATIONS CAREFULLY ON REVERSE SIDE.

STUDENT INFORMATION COLLEGE YOU: ( ) Attend ( ) Plan to Attend Name______Name of College ______SS# ______Address ______Birth Date ______Major ______Address ______Expected College Graduation Date ______College Accum. GPA ______Accum. Hrs. ______Telephone ______Est. Accum. Hrs. as of end of current school year ______Meigs Co. Resident? ______ESTIMATED COST OF EDUCATION How Long? ______Tuition & Fees $ ______Employed? ______Where ______Room & Board $ ______Marital Status ______Books & Supplies $ ______Spouse’s Employment ______Personal Expenses $ ______Transportation $ ______PARENT INFORMATION Other Expenses $ ______Father’s Name ______TOTAL $ ______Father’s Address ______FINANCIAL AID & OTHER RESOURCES ______Ohio Instructional Grant$ ______Mother’s Name ______College Work Study $ ______Mother’s Address ______Nat’l Direct Student Loans$ ______Pell Grant $ ______Father’s Employment ______Stafford Loan $ ______Mother’s Employment ______Other Scholarships $ ______Other Resources $ ______HIGH SCHOOL INFORMATION TOTAL $ ______Graduated from ______Year Graduated ______

PLEASE ATTACH A COPY OF YOUR CURRENT FEDERAL INCOME TAX RETURN Adjusted Gross Income Figures 1) Father $ ______Mother $ ______Joint $______2) Student $ ______Spouse $ ______Joint $ ______NOTARY STATE OF OHIO, ______COUNTY, SS: ______, being first duly sworn, says that all facts set forth in the foregoing application are true, and further certifies that the Federal Income Tax Form attached is for the current income year.

Applicant Signature: ______

Sworn to before me and subscribed in my presence this ______day of ______, 20__.

Notary Public Signature______

QUALIFICATIONS FOR APPLICANTS 1. Kibble Foundation Scholarship Grants are available only at the following institutions: The Ohio State University, Ohio University, University of Rio Grande, Rio Grande Community College, Marietta College, Hocking College and Washington State Community College. 2. Recipients must be U.S. Citizens and graduate of a Meigs County High School. This includes residents of Meigs County’s Columbia Township who graduate from Alexander High School (If you did not graduate from one of these schools PLEASE DO NOT file this application). 3. The scholarship grants are available only to undergraduate students for both associate degrees and four- year bachelor degrees. 4. A student may be given the scholarship until he or she attains 200 quarter hours of 133 semester hours, unless the bachelor’s program requires more than that (i.e., a 5 year ENT program- required academic departmental approval). 5. To be eligible you must be full time student. 6. An application may be submitted to only one school. 7. This application must be filed with the school on or before May 15, 2019 to be considered for the upcoming school year. 8. Returning students must maintain a cumulative GPA of 2.0 or higher.

I have ready the above criteria and meet qualifications for the application.

Signature of Applicant: ______Date

** NOTE: No application will be considered for scholarship which is not filed before May 15, 2019, with the college/university you plan to attend. Do no wait; file your application early. You may submit an application for only one college or university.

** NOTE: It shall be the responsibility of each applicant to be sure that the application has been received by the college or university before the deadline. The application must be filed with the school and not the Trustee. Get your application filed early and verify with the school that they received the application. You may want to file a duplicate and have the school return a file-stamped copy to you.

** NOTE: It should be pointed out that the scholarship is granted to the school of your choice and is not transferable to any other school. If you transfer during the year, then you will forfeit the remaining portion of this scholarship for that school year and unused money will remain in the Foundation resources. If you transfer to another approved college you can then make application for the next school year.