LAFAYETTE PARISH SCHOOL SYSTEM SUPERINTENDENT’S SCHOLARSHIP GOLF TOURNAMENT 2017 SCHOLARSHIP INFORMATION SHEET PURPOSE: The Lafayette Parish School System organizes its annual Superintendent’s Scholarship Golf Tournament to fund college scholarships for students graduating from Lafayette Parish Public Schools. Members of the Scholarship Committee look for students who show academic potential, a desire to succeed, and who have a financial need. ELIGIBILITY: Applicants must meet the following criteria: 1. Begin his/her freshman year in 2017-2018 at an accredited Louisiana college, university, or vocational-technical school 2. Enroll as a full time student (12 or more hours) 3. Finish high school with an overall 2.5 G.P.A. or higher on a 4.0 scale or have earned a high school equivalency diploma through the Lafayette Parish School System’s Adult Education Program or the Exiting Pathways Program with a minimum total score of fifty on the HiSET. 4. Demonstrate financial need SELECTION AND AWARD: A committee will review scholarship applications and select recipients. The Superintendent’s Scholarship Committee will award scholarships to the designated applicants based on funds available. Maximum scholarship allocation will be $3000. Recipients may use the funds for school-related expenses such as tuition, fees, books, or room and board. Checks will be made payable directly to the university or college when the recipient presents related documentation. Scholars will receive half of the funding in August for the fall semester; half of the funding in January for the spring semester, provided the recipient has completed the fall semester as a full-time student and maintained a 2.5 G.P.A. or higher. Money not claimed within two (2) calendar years of this award will be returned to the scholarship fund. THE SCHOLARSHIP MUST BE USED FOR EDUCATION EXPENSES SUCH AS TUITION, BOOKS, ROOM/BOARD, ETC. (If student is eligible for TOPS, this scholarship cannot be used for tuition.) APPLICATION PACKAGE: Consideration will be given only to applicants submitting an application packet, which must include the following: 1. Parent or guardian’s official verification of income (copy of signed current federal tax return or proof of income) 2. Completed application form, including the essay 3. Current high school transcript or HiSET results report 4. Copy of ACT/SAT results 5. Names of two (2) references (one academic, one non-academic) APPLICATION DEADLINE: Completed application packet must be submitted, no later than Wednesday, May 10, 2017 to the LPSS Superintendent’s Scholarship Committee, Lafayette Parish School System, P O Drawer 2158, Lafayette, LA 70502, ATTN: Randy Bernard, Academic Specialist. Notification of scholarship award will be announced in May 2017.
2016 LPSS Superintendent’s Golf Tournament Scholarship Application Form
Applicant Last
First
Middle
Street
City
State
Zip
State
Zip
State
Zip
Home Address
Date of Birth
Age
Sex M
F ___ Social Security #
Home Phone
Work Phone (student)
Father/Guardian
Home Phone
Home Address (If different from student)
Street
City
Employer
Phone
Employer’s Address Street Mother/Guardian
City Home Phone
Home Address (If different from student)
Street
Employer
City
State
Zip
State
Zip
Phone
Employer’s Address Street Number of Siblings
City
Their ages
*Family Income: $______________ per year - ATTACH COPY OF SIGNED TAX RETURN FOR 2016 OR PROOF OF INCOME. *NOTE: Application will not be considered without this information. Please explain special financial need
College to which you plan to apply *Must be an accredited college, university or technical school in the state of Louisiana. Letter of acceptance is required prior to awarding of scholarships.
Expected date of enrollment
Intended Major
Scholarships/Grants applied for
Scholarships/Grants received
Overall academic grade point average Total Score on ACT
on a 4.0 grade point scale or HiSET score _______ or SAT
Date of Exam
Present High School OR circle the program completed: LPSS Adult Education or LPSS Exiting Pathway Address Street Principal
City
State Phone
List School Activities & Honors--include leadership positions (attach separate page(s) if necessary)
Community Activities--include leadership positions (attach separate page(s) if necessary)
Honors Received (attach separate page(s) if necessary)
Part-time/Summer Employment
Zip
Give the names, addresses and telephone numbers of two (2) references other than members of your family: Academic Reference Name
Phone
Address Street
City
State
Zip
State
Zip
Relationship to Applicant
Non-Academic/Community Reference Name
Phone
Address Street
City
Relationship to Applicant
Essay - Tell the committee about yourself (briefly explain why you should receive this scholarship.) Attach the essay to your application. NOTE: Applications will not be considered without this essay.
I HEREBY STATE THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. NOTE: Any scholarship money that has not been initially accessed in any form within two years of the awarding of the scholarship will be forfeited and returned to the scholarship fund.
Applicant’s Signature
Date
Parent’s/Guardian/s Signature
Date
Principal’s Signature
Date
NOTE: All information submitted will be made available only to members of the selection committee and will be held in the strictest of confidence.