Ida Ballard Simon

2011 Book Scholarship Application

 

Name:  _____________________________________     Phone No:_____________________

 

Address:     _________________________________________________________________

 

E-Mail Address:  ____________________________________________________________

 

City ________________________________State ___________ Zip Code   _____________

 

Parents or Guardians:______________________________________________________

 

Section 1: Financial Need

 

What is the total number of persons living in the household (including yourself)? ______

 

Parents/Guardian household income:

 

________  less than $20,000 ________  $20,000-$40,000  _____  greater than $40,000  ______

 

How many people living in your household are currently in college?________________

 

List any scholarships and/or financial aid commitments that you have received:

 

Section 2: Academic Achievement- Will be determined from required official transcript.
 

Section 3: SCHOOL ACTIVITES & HONORS

List your membership in high school organizations and clubs:

Clubs or Organizations	Number of Years Involved	Offices Held

 

List high school honors, awards & recognitions:

Honor/Distinction	Year Awarded	Explain the basis for the award

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Section 4: Community Involvement (Do not duplicate School Activities if listed above.)

List your community involvement activities

Clubs or Organizations	Years Involved	Offices Held

 

List the HBCUs or technical schools to which you have applied. Please indicate the ones to which you have

been accepted.

 

HBCU/Technical School                                                            City/State                                  Accepted?

 

_______________________________________        _________________________       Yes   No

 

_______________________________________        _________________________       Yes   No

_______________________________________        _________________________       Yes   No

 

_______________________________________        _________________________       Yes   No

  

If yes, please provide acceptance letter.

  

What is your anticipated major? _________________________________________________________

 

 

What are your objectives? _____________________________________________________________

 

___________________________________________________________________________________

 

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  Scholarship Policies and Procedures

 

1. All applicants MUST be 2011 graduating seniors of the City of Memphis public school system.

 

2. Applicants MUST receive a high school diploma during the 2010-2011 school year and have proof of acceptance and enrollment to a HBCU (Historically Black College or University) or technical school for the upcoming 2011-2012 school year.

 

3. Applications must be submitted by the published deadline with a postmark date July 15, 2011.

 

4. Applications should be mailed to:

Ida Ballard-Simon Book Scholarship 2011

P.O. Box 770113          

Memphis, TN 38177

 

5. Priority will be given to applications that are submitted and received by the deadline date.

 

6. Applications are considered complete when ALL of the following required information is received:

1. Letter of recommendation from a teacher.
2. Letter of recommendation from a non-relative.
3. An Official Transcript which includes the cumulative grade point average, class rank and class size (if not available, ask guidance counselor for percent ranking in class).
4. ACT and/or SAT score
5. Completed application with essays (required Essay Topics are referenced on page 4 of this document)
6. Attached graduation photo
7. Acceptance letter from HBCU or technical school

 

If any of the aforementioned supporting documents are not received by the published deadline, the application WILL NOT be given priority status with respect to the distribution of scholarship awards.

 

7. Each applicant is REQUIRED to participate in an interview with the book scholarship selection committee.

 

8. Each applicant is RESPONSIBLE for contacting the committee at 901-292-7630, to arrange an interview time.  Tentative dates are scheduled for July 22-28 2011.

 

9. Failure to schedule AND attend the scholarship interview will result in a LATE and INCOMPLETE application. No written or verbal confirmation will be provided for the interview.

 

10. All information submitted on the attached application will be considered confidential and will not used for any purpose other than to determine scholarship awards.

 

11. All information received shall become the property of the Scholarship Committee.

 

Scholarship awards are final, non-repeating and non-transferable. Any awards not collected during the 2010 Fall and 2010 Spring semesters will not transfer to the next calendar semester or year.         

 

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  Essay

 

  Please choose one of the following topics as your Essay Topic.

  Please limit your response to one (1) type written page.

 

 

1.         Discuss what has your greatest accomplishment. What obstacles have you overcame to achieve this accomplishment?

 

2.         What has been your greatest challenge as a young person? How did you handle the challenge?

 

3.         Share three (3) specific ways your school experience has helped you prepare for college.

 

4.         Discuss your thoughts on current and future impacts that the oil spill has on life.

 

5.         What are your professional/long time goals?

 

6.         Discuss your thoughts about the upcoming 2012 Presidential Election.

 

 

Verify that the information in this application is accurate and true by signing below.

 

 

____________________________                            ___________________________

Scholarship Applicant        Date                                 Parent/Guardian                  Date

 

 

 

____________________________                            ____________________________

 

Scholarship Coordinator   Date                                  Guidance Counselor            Date                              

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