Howard Hill Memorial Eagle Scout Scholarship Fund

Eagle Scout Scholarship Application For all Academic Years APPLICATION INSTRUCTIONS AND CHECKLIST

1. Scholarships are $1,000 per semester of enrollment up to a maximum of 12 semesters ($12,000) in an approved institution of higher learning to include but not limited to a state of Kentucky college, university, junior college, or technical school in pursuit of an undergraduate degree, a post graduate degree (up thru a Masters degree), or a technical certification 2. Scholarships are provided by donations of Eagle Scouts of BSA Troop 164 of Shelbyville, Kentucky, Shelby County, USA; friends of Troop 164 Eagle Scouts; and former scholarship recipients thru the Howard Hill Memorial Eagle Scout Scholarship Fund as administered by the Community Foundation of Louisville. 1. This application form will be made available to all Shelby County BSA troops thru their sponsoring organizations, their scoutmaster, and the Lincoln Heritage Council District Executive responsible for Shelby County. 3. A maximum of 2 scholarships may be awarded each year; one in honor or Troop 164 Eagle Scout Jason Wilder and another in honor of Troop 164 past Scoutmasters. 4. Each candidate for scholarship must submit this request for scholarship, whether new application or a renewed application, each year. 5. Each new candidate for scholarship must be a US Citizen; must have earned the rank of Eagle Scout while a member of a Shelby County Kentucky troop properly register with the Lincoln Heritage Council of the Boy Scouts of America; and be a member in good standing of that troop. 6. New applicants must submit this application by May 1 of their high school senior year and be enrolled in high school. 1. New applicants must also provide proof of application and and proof of acceptance at the institution of higher learning of their choice. 7. Renewing applicants must submit this application by May 31 or the institutions school year for consideration of award for the next fall semester. 1. Renewing applicants must also provide proof of continued enrollment in the institution of higher learning of their choice. 2. Renewing applicants must provide a transcript certifying their successful completion of the previous institutional year, award of undergraduate degree or technical certification. 8. This application must be filled out in its entirety leaving no blanks. If additional space is needed, please attach a separate sheet of paper for the continuation of the topic. 9. New applicants must provide a copy of their high school transcript and be graduating with a C or better cumulative grade point average. 10. New applicants must provide a copy of their Eagle Scout certification. 11. New applicants must submit at least two (2) letters of recommendation with this application from persons in the following areas of knowledge of the candidate (no more than one (1) letter from each area of knowledge): scouting, church, community, or school. 12. Each scholarship will be issued in the form of a Certificate of Award by the Howard Hill Memorial Eagle Scout Scholarship Fund, conditioned upon the enrollment of the individual as a full-time student in the program of choice within the calendar year the scholarship is awarded. The award will be paid as scholarship funds directly to the school in which the student is enrolled. “Verification of Student Enrollment” and “Special Instructions to the Institution of Higher Learning will be provided to the student to use in requesting funds. 13. The award may be used for tuition, books, student fees, laboratory fees. Room and board (if housed on campus). 14. The scholarship will not cover expenses or payments for an academic year prior to July 1 of the year in which the scholarship is awarded. 15. Applications may be submitted electronically as PDF documents attached to an e-mail addressed to [email protected] with the subject heading Eagle Scout Application 16. Applications may also be submitted as a paper poackage by mailing the entire packet in a binder to: Howard Hill Memorial Eagle Scout Scholarship Fund; c/o Richard Walker; 673 Hempridge Rd; Shelbyville, Ky 40065 17. Applications will not be returned to the applicant regardless of the outcome of the selection. Applications not selected will be destroyed by shredding for the purposes of keeping the applicants information confidential. Applications selected will be kept on file for a period of 5 years after the applicant has received the final award, then the application will be destroyed by shredding; however the applicants name will be kept on record for as long as the fund deems appropriate for the purposes of encouraging other applicants. Howard Hill Memorial Eagle Scout Scholarship Fund

Eagle Scout Scholarship Application For all Academic Years

Applicants Name ______Address ______

City ______State ______Zip ______

Phone Number ______Date of Birth ______

Date of Eagle Scout Award ______Troop with which Awarded ______

Number of Years with this Troop ______Number of Years as a Scout ______

Number of Years in Cub Scouting ______Arrow of Light recipient ______Year of Award _____

High School Attending ______Graduation Year ______

Class Ranking ______Grade Point Average ______SAT Score ______ACT Score ______

Parent or Guardian Information:

Fathers / Guardians Name ______Employer ______

Job Title of Position ______

Mothers / Guardians Name ______Employer ______

Job Title or Position ______

Number of Siblings at Home ______Number of Siblings in College ______

Other Scholarships awarded (please list):

Awarded By Amount

Honors and Awards: ______Extracurricular Leadership Activities (school, community, ROTC, clubs, etc) ______

Community Service: ______

Briefly describe your Eagle Scout service project: ______

Describe your Leadership Role in the Troop and your leadership responsibilities with your service projects: ______

If additional space is needed for any topic please type its continuation it on a separate paper and attach to the end of this form. Howard Hill Memorial Eagle Scout Scholarship Fund

Eagle Scout Scholarship Application For all Academic Years

Applicant Certification: I certify the accuracy of the foregoing facts. I give my permission for the Howard Hill Memorial Eagle Scout Scholarship Fund to use my name and to quote from my application in news and other publicity.

Date ______Signature ______

Parent/Guardian Consent: I/We certify that the information pertaining to my/our son is true and correct and I/we hereby waive any claim against Howard Hill Memorial Eagle Scout Scholarship Fund

Date ______Signature ______

Boy Scout Leader: The above applicant is qualified in every respect to represent the Howard Hill Memorial Eagle Scout Scholarship Fund and has my recommendation.

Date ______Signature ______

Howard Hill Memorial Eagle Scout Scholarship Fund committee approval:

Committee Chairperson: ______Approved ______Disapproved ______

Committee Member: Recommend Approval ______Recommend Disapproval ______