<p>2013 Osage Scholarship Application- Form B Name:______Due: February 1, 2013</p><p>The following local organizations use this Osage scholarship application form b—read and decide upon the scholarships for which you would like to be considered. If you are applying for more then one scholarship, make a copy of the entire application for EACH scholarship. Each front page should have only one scholarship checked. Complete the application using Microsoft Word.</p><p>Note: Some scholarships are requesting additional information. Please include that</p><p>_____ Kiwanis Club Scholarship- open to any student</p><p>_____ Lions Club Scholarship- open to any student</p><p> The Osage Lions Club is requiring an additional paragraph of 200 words or less attached to the 2013 Osage Scholarship Application- Form B that addresses your views on community service. Please include the following in a typed paragraph.  Choose one of your community service projects and describe its importance to you. What have you gained or learned from doing the project? How has it impacted or changed something or someone?</p><p>_____ Rotary Club Scholarship- open to any student</p><p>_____ Marian Stibal Memorial Scholarship- open to those planning to teach</p><p>_____ Norbert Mullenbach Memorial Scholarship- open to any student</p><p>_____ OEA Scholarship- open to those planning to teach</p><p>_____ Osage Chamber of Commerce Scholarship- open to students who are residents of Osage</p><p>_____ Osage Education Foundation Scholarship- open to any student</p><p>_____ Ramker Scholarship- preference given to student with an interest in pursuing a career based in music</p><p>_____ Raub Scholarship- student must be pursuing a four year college program & have a 3.0 grade point average</p><p>_____ Francis Jeffries Scholarship- preference to students attending University of Iowa</p><p>_____ Steven Funk Scholarship- applicants must demonstrate exemplary academic credentials coupled with broad-based participation in school and community activities</p><p>_____ VFW Post 7920</p><p>Edited 12-21-12 2013 Osage Scholarship Application- Form B Name:______Due: February 1, 2013</p><p>Complete this application using Microsoft Word or another word processing program.</p><p>General Information Your Name (Last, First, Middle Initial):</p><p>Address: County: Telephone Number: Mother’s Name: Father’s Name:</p><p>How many years have you resided in Iowa? _____ Have you ever been convicted of a misdemeanor or felony, excluding minor traffic violations? Yes / No Have you served ineligibility due to a violation of the District’s Good Conduct Policy? Yes / No Have you ever had an In-School or Out-Of-School Suspension? Yes / No Have you been involved in a founded bullying incident? Yes / No If yes to any of these, please explain.</p><p>College Plans Name of School: Semesters of courses enrolled in/taken grades 9-12: City and State of School: Math ____ Are you accepted at the college? Yes___ No___ Science ____ English ____ Intended degree or program : (check all that apply) Social Studies ____ Certificate or Diploma program ___ Foreign Language ___ Associate Degree or two year program ___ Elective courses: ____ Bachelor’s Degree or four-year program___ More than a Bachelor’s Degree ___ Number of college credits earned in high Other ___ school: ______</p><p>Major field/area of study:</p><p>Edited 12-21-12 2013 Osage Scholarship Application- Form B Name:______Due: February 1, 2013</p><p>School Activities</p><p>In the tables below and on the next page, mark all extracurricular activities you have participated in during high school and plan to participate in including spring and summer activities. Extracurricular Activities 9 10 11 12 Basketball Baseball Cheerleading Basketball Cheerleading Football Cheerleading Wrestling Cross Country Football Golf Manger- Basketball Manager- Cross Country Manager- Football Manager- Track Manager- Volleyball Manager- Wrestling Tennis Track Trap Shooting Soccer Softball Swimming Volleyball Wrestling</p><p>Other School Organizations 9 10 11 12 Big Brother/Sister FCCLA FFA FTA IT Club JEL Speech Club Student Council</p><p>Edited 12-21-12 2013 Osage Scholarship Application- Form B Name:______Due: February 1, 2013</p><p>Activity 9 10 11 12 Ensemble contest for band Ensemble contest for choir FFA Career Development Event FFA Leadership Contest FFA Leadership Conference Flag Team Individual Speech Contest Honor Choir Jazz Band Jazz Choir Large Group Speech Contest Musical Play Show Choir Solo Contest- Band Solo Contest- Choir Variety Show 4-H Boy/Girl Scouts Dance Club Other: </p><p>Please include leadership positions here. Identify awards or honors you have received. Leadership Position or Award/Honor 9 10 11 12</p><p>Work Experience</p><p>Edited 12-21-12 2013 Osage Scholarship Application- Form B Name:______Due: February 1, 2013</p><p>Record work experience in grades 9–12, including summers. Add up total hours worked per job to March 1 of this year and include on this application. DO NOT include job if hours per week are over 40 during the school year. From To Total Employer and Supervisor Position (Mo/Yr) (Mo/Yr) Hours </p><p>A & W, Joan Doe Dishwasher 6/2009 9/2010 480</p><p>Community Involvement/Volunteer Service</p><p>List community involvement while in grades 9-12. Examples of involvement may include: Scouts, church, 4-H, and helping community organizations such as the Bloodmobile, Rotary, etc... Include the average hours per week for any ongoing project. Write down the total hours per project up to March 1 of this year. </p><p>Organization Project and Supervisor Date: Total Hours (Mo/Yr) 4-H Sock Sale 10/2011 2</p><p>Goals</p><p>Edited 12-21-12 2013 Osage Scholarship Application- Form B Name:______Due: February 1, 2013</p><p>Type a statement about your career and educational goals and explain why you chose the field or major area of study. What sort of advantages and disadvantages do you foresee facing as you work toward your goals? (500 words minimum)</p><p>Certification</p><p>Edited 12-21-12 2013 Osage Scholarship Application- Form B Name:______Due: February 1, 2013</p><p>I certify that the information provided is accurate and complete to the best of my knowledge. I give the scholarship committee permission to verify any information on this application. I understand that any false information may disqualify me from a scholarship.</p><p>Scholarships are given as free grants with no obligation to be repaid. This money was made available through the generosity of past Osage graduates and other donors. I understand that the scholarship committee would like me to consider making a contribution to the scholarship fund sometime in the future when I am financially able.</p><p>Signature of applicant ______Date ______</p><p>Signature of parent/guardian______Date ______</p><p>DO NOT WRITE BELOW THIS LINE ______</p><p>Completed application turned in by deadline. Yes___ No ___ </p><p>Due ______</p><p>Character ______Number of days absent for seven semesters______</p><p>Attendance ______Number of times tardy for seven semesters______Academics ______</p><p>School Activities ______Latest ACT Composite ______</p><p>Work Experience ______Seventh semester total grade points ______</p><p>Community/Volunteer ______Cumulative GPA for seven semesters ______College Plans ______Seventh semester class rank ______Goals ______</p><p>Interview ______</p><p>Total Points ______</p><p>Edited 12-21-12 2013 Osage Scholarship Application- Form B Name:______Due: February 1, 2013</p><p>Edited 12-21-12</p>