<p> Character Counts Scholarship Application</p><p>Priority Deadline – September 30, 2016</p><p>(applications received after priority deadline will not be eligible)</p><p>First: ______Last: ______MI ______</p><p>Mailing Address: ______</p><p>City State Zip Code</p><p>Telephone Number: ______</p><p>E-mail address: ______</p><p>Part I. Scholarship Information</p><p>ONLY COMPLETE APPLICATIONS WILL BE CONSIDERED</p><p> Scholarship recipients will be selected on criteria listed below.</p><p> Only current high school juniors and seniors who reside in the state of New Mexico are eligible to participate.</p><p> Three (3) - $500 awards will be given from all completed applications received by application deadline of September 30th, 2016.</p><p> Character Counts Scholarship funds are provided by the New Mexico Broadcasters Foundation.  Employees or immediate family members of any iHeartRadio station or New Mexico Broadcasters Foundation are not eligible to participate.</p><p>Part II. Complete the following items</p><p>1) Residence information: ( ) San Juan County, NM ( ) County, State)______</p><p>2) Current grade level: ( ) 11th ( ) 12th Name of High School:______</p><p>3) Will you be attending any post-secondary institution in 2017 (vocational or university)_____</p><p>Part III. Answer the following questions</p><p>Applicants must answer all questions below using the following format.</p><p>Format of essay: 1) Answer each question in less than 500 words. 2) Typed; Double-spaced; One-inch margins; 12 point font. 3) Permitted formats of the entry: Portable Document Format (PDF) or Microsoft Word Document. 4) Your name must be on the essay.</p><p>Submissions will be judged on: 1) Relevancy (stick to the topic). 2) Sincerity. 3) Persuasiveness using emotion of essay. Answers will be used to select award recipients. Please attach additional sheets if more space is necessary.</p><p>What are your short-term and long term educational and career goals? Describe how your educational plans will advance your career path. What extra-curricular activities have you been involved in? Any clubs, sports, music or community-service activities? Tell us how they have helped you or others and if you will continue with any of the interests. </p><p>What does “Character Counts” mean to you?</p><p>Part IV. Signature and Information Release Authorization</p><p>The above information and any attached documents are true and correct to the best of my knowledge. I give my consent to share any information above with iHeartMedia, the New Mexico Broadcasters Association and the New Mexico Broadcasters Foundation.</p><p>PRINTED NAME:______</p><p>SIGNATURE: ______DATE: ______</p><p>Mail completed applications by priority deadline of September 30, 2016 to:</p><p> iHeartMedia, </p><p>200 East Broadway, </p><p>Farmington, NM 87401</p><p>Attn: Dave Schaefer</p><p>Phone: (505) 325-1716</p><p>Or </p><p>E-mail completed applications by priority deadline of September 30, 2016 to:</p><p> [email protected]</p>