<p> 2010 MATTHEW WILLIAM MOORE SCHOLARSHIP</p><p>ADMINISTERED BY THE FAYETTEVILLE PUBLIC EDUCATION FOUNDATION, INC.</p><p>INSTRUCTIONS: THIS APPLICATION IS ONLY FOR STUDENTS ENROLLED AT FAYETTEVILLE HIGH SCHOOL. Applicants must complete all items in each Section and return the form to Ms. Anne Butt by Friday, April 2, 2010. You must attach a current transcript covering the last seven academic semesters and two photographs of yourself. Two letters of recommendation are also required by the deadline and may be sent to Ms. Butt under separate cover or attached to this Application.</p><p>CRITERIA FOR SELECTION OF RECIPIENTS:</p><p>1. Each recipient must be enrolled at Fayetteville High School, eligible for graduation, and accepted for college enrollment.</p><p>2. Each recipient shall show areas of interest and talent. Of special significance will be the recipient’s plans for the future.</p><p>3. Each recipient will have shown positive contributions to Fayetteville High School.</p><p>4. Academic achievement, grade point average, and class ranking will be considered, but are not the only determining factors for award of the scholarship. It is recommended that the recipient be in the top ten percent (10%) of the graduating class and have a 30 ACT.</p><p>5. Financial need and family circumstances will be considered. SECTION I: PERSONAL DATA</p><p>Name______</p><p>Permanent Address______</p><p>City______State______Zip______</p><p>Home Phone______Cell Phone______Social Security Number______</p><p>Parents’ Names______</p><p>Parents’ Address(es) (If different from above)______</p><p>______</p><p>Father’s Occupation______</p><p>Mother’s Occupation ______</p><p>Brothers / Sisters (Give name, age and years of education) ______</p><p>______</p><p>______</p><p>SECTION II: FINANCIAL INFORMATION</p><p>College Expenses: Tuition $______Room & Board $______Books $______</p><p>Other Expenses (Itemize) $______</p><p>Other resources available to you for the year for which you are applying (ALL sources and amounts such as social security, tuition credits, savings, etc.):</p><p>Other Scholarships for which you have applied (name the scholarship, the amount, and whether you have received it, if it has been declined, or is still pending).</p><p>Federal / State agency grants or loans (same information as above):</p><p>Brothers / Sisters / Parents Attending College (give name(s) and college(s)): ______</p><p>MATTHEW WILLIAM MOORE SCHOLARSHIP Application Page 1 SECTION III: EDUCATIONAL INFORMATIO N</p><p>High School Class Size ______Your Class Rank ______Grade Point______</p><p>College Admission Test Scores (Name each test then give your score and the date the test was taken):</p><p>College you plan to attend next fall semester: ______</p><p>SECTION IV: EXTRACURRICULAR ACTIVITIES</p><p>Please list those areas under each category in which you have been active and/or made significant contributions. If you prefer, attach your resume in lieu of completing this Section IV.</p><p>LEADERSHIP (offices held, leadership experience, awards)______</p><p>ACADEMIC (honor organizations, achievement awards) ______</p><p>CREATIVE (music, art, dramatic and literary involvements, awards) ______</p><p>ATHLETIC (sports, spirit groups, recognitions) ______</p><p>VOLUNTEER / COMMUNITY SERVICE ______</p><p>WORK EXPERIENCE ______</p><p>OTHER ______MATTHEW WILLIAM MOORE SCHOLARSHIP Application Page 2 SECTION V: PERSONAL NARRATIVE Type or print on a separate sheet of paper, a brief narrative for each of the following: (Please limit to a total of two pages – one side only)</p><p>1. What options and interests do you see for yourself in the future?</p><p>2. Share a personal story from your life that reflects something that is important to you.</p><p>3. Why have you applied for this scholarship?</p><p>4. Share the reasons for choosing your particular college or university.</p><p>5. Is there anything else you want us to know about you?</p><p>SECTION VI: ATTACHMENTS</p><p>A. List two personal references other than family members (at least one must be a high school teacher). Attach letters of recommendation from each one, or request they be sent under separate cover. Name Address Phone No. Relationship Years Known </p><p>1. ______</p><p>2. ______</p><p>B. Please attach two photographs made during the last year.</p><p>C. A transcript covering your last seven semesters, plus the first grading period of the current semester, must also be attached to be considered for a scholarship.</p><p>SECTION VII: CERTIFICATION</p><p>My signature below certifies that I am currently enrolled in Fayetteville High School, I have completed the requirements for graduation, and I will attend the college of my choice for one year. My signature further certifies that all information and statements provided by me on this application are true and correct to the best of my knowledge. In addition, I authorize Fayetteville High School to release any information included in this application to the Matthew William Moore Scholarship Committee.</p><p>______Date:______(Signature) </p><p>MATTHEW WILLIAM MOORE SCHOLARSHIP Application Page 3</p>