<p> APPLICATION Friends of Gumbo Limbo 2017 Gordon Gilbert & Charles N. Kurucz Memorial Scholarship (HS Level)</p><p>S TUDENT INFORMATION:</p><p>Name: </p><p>Address: </p><p>Cell: Home #: </p><p>Email: </p><p>Name of High School : </p><p>Have you previously volunteered 100 or more hours at Gumbo Limbo Nature Center? (note: This will not affect your eligibility for scholarship awards.) ______</p><p>Science Courses Completed and Grades Received:</p><p>GPA - Science Courses: GPA Overall: </p><p>HPA- Science Courses: HPA Overall: </p><p>List and describe your science and/or environmentally oriented extracurricular activities:</p><p>Planned College /University Information:</p><p>Intended Field of Study/Profession: ______</p><p>Degree Sought : ______</p><p>Name of College/University: ______</p><p>Address: ______</p><p>HS scholarship application October 21, 2013 APPLICATION Friends of Gumbo Limbo 2017 Gordon Gilbert & Charles N. Kurucz Memorial Scholarship (HS Level)</p><p>Reference Information :</p><p>Please note: A letter of Reference from a Science Teacher or Guidance Counselor is required.</p><p>Reference Name: </p><p>Reference Title: </p><p>High School Student Essay (< 500 words):</p><p>Please summit an essay (not to exceed 500 words) describing the significance of your contributions to the mission of Gumbo Limbo Nature Center, and how you intend to use your education to further that mission in the future. Please refer to the scholarship announcement for the mission statement.</p><p>*For the Charles N. Kurucz Scholarship Only (must qualify for at least one of the following)</p><p>___ I am eligible for the Free & Reduced Price School Meals program and my documentation is attached. Please have your guidance counselor provide written confirmation of your eligibility for this assistance program.</p><p>___ I am a first generation college student. By signing this, I am claiming that no member of my immediate family as defined as parents, step-parents, or grandparents have graduated college. If this is found to be false, then I acknowledge that this scholarship may be void and I will be responsible for repaying Friends any scholarship funds distributed based on false statements.</p><p>If either of the above statements is true, please list ALL science courses offered by your school (even the classes you did not take). You can acquire a list from your school’s Science Department Chair: ______</p><p>I attest that all the information that I have provided in this application is true and accurate.</p><p>Printed Name: ______Signature: ______</p><p>Date: ______</p><p>HS scholarship application October 21, 2013 APPLICATION Friends of Gumbo Limbo 2017 Gordon Gilbert & Charles N. Kurucz Memorial Scholarship (HS Level)</p><p>Completed Application Deadline: February 10, 2017</p><p>Please return your completed application form, along with your essay, the reference letter, and a copy of your school transcript to:</p><p>GUMBO LIMBO NATURE CENTER ATTN. GORDON GILBERT SCHOLARSHIP 1801 N.OCEAN BLVD., BOCA RATON, FL.33432</p><p>Or Email to: Brandon, Scholarship Coordinator ([email protected])</p><p>HS scholarship application October 21, 2013 </p>