Doug Dohey Memorial Scholarship Application-2018 Administered by the Suffolk Education Foundation

Doug Dohey was raised in Forbes Road, PA and a graduate of Greensburg Salem High School, Greensburg, PA, and California University of Pennsylvania, California, PA. Doug answered the call to serve as an educator for his entire professional career with Suffolk Public Schools. Beginning as a teacher at Booker T. Washington Middle School, he moved on to serve as a counselor at Driver Intermediate and Nansemond River High School. In 1990, he instituted the first wrestling program at Nansemond River...his labor of love. Today that program is successful based largely on Doug's initial efforts and years of dedication. Progressing from teaching, counseling, and coaching, Doug moved toward administration where he worked as an Assistant Principal at John F. Kennedy Middle School and Principal at John Yeates Middle School before joining Suffolk's central office as Coordinator of Middle School Education. Doug retired as Chief of Operations for Suffolk after 33 years of public school service. Doug devoted his life to the families of Suffolk and treasured the relationships he cultivated there. In honor of Doug Dohey, the Suffolk Education Foundation will administer a $1,500 Scholarship to a High School Senior who actively participated on their school’s Wrestling Team. ELIGIBILITY – The applicant shall be: 1. A student who will graduate this year from a public high school within the City of Suffolk and is a resident of the City of Suffolk; 2 A student who has demonstrated excellence in academic studies and in school and community activities, and has a financial need to continue their education; 3. A student who has wrestled during the 2017-2018 school year at one of the public high schools in Suffolk; and 4. A student who plans to attend an institution beyond the high school level that is accredited by a regional accreditation association, including two year colleges, nursing schools, trade/technical schools and fine arts institutes. The award is a grant and not a loan to be repaid by the recipient. Notification of awards will be made in May. The scholarship award will be paid in one full payment directly to the college of the applicant’s choice. The SEF will forward a check in the designated amount of the award to the Financial Aid Office of the institution after the recipient is admitted. A copy of the applicant’s letter of acceptance to an accredited institution must be on file before an award check will be mailed. Scholarship applications will be scored without names on them. Student ID# must be included at the top of each page. Applicants should refrain from putting their name on pages beginning with Section 6 through the end of the application and attachments. Only information on pages five and six and attachments will be scored.

Suffolk Public Schools Student ID # _______________________

NAME OF HIGH SCHOOL _______________________________________________ 1. APPLICANT INFORMATION FULL NAME __________________________________________________________ Last First Middle Initial MAILING ADDRESS ____________________________________________________ Number Street (or PO Box if applicable) Apt.# City ________________________ State ________Zip________ PHONE ( ____ )____________________E MAIL______________________________ PARENT/GUARDIAN NAME ______________________________________________

2. APPLICATION CHECKLIST This scholarship application becomes complete and valid only when you have enclosed the following materials and completed the following tasks: Student application Essay Resume of school and community activities Two letters of recommendation – 1 from a high teacher/counselor/administrator and 1 from the wrestling coach at the student's high school Copy of Student Aid Report (SARS) received after submitting FAFSA application (required of all applicants - applications will not be reviewed without the SARS) Initial Rules and Regulations in Section 4 Sign and date Certification in Section 5

3. STUDENT AID REPORT (SARS) The Doug Dohey Memorial Scholarship is administered by the Suffolk Education Foundation. All students applying for Suffolk Education Foundation scholarships are required to submit the Student Aid Report (SARS) that you will receive after completing and submitting the Free Application for Student Aid (FAFSA). Information from the SARS will be used to determine financial need. Remember, complete and submit your FAFSA early so that you will have your SARS before submitting this scholarship application.

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Suffolk Public Schools Student ID # _______________________ 4. RULES AND REGULATIONS Please read and initial each paragraph indicating that you understand and agree with the rules and regulations governing any potential scholarship awards made based on this application. Student and parent/guardian must initial each paragraph. A. In order to be eligible for a scholarship, applicants must complete the application in its entirety and return it to the Suffolk Education Foundation by midnight, March 28, 2018. By submitting an application to the Suffolk Education Foundation (SEF) Academic Scholarship Program, I hereby consent to the SEF’s ownership of all rights in and use of my essay or other personal information therein. The SEF shall have the right, and may permit others as it sees fit, to dispense, reproduce, and otherwise use my name, essay, likeness, biography, photograph, and other pictures in connection with the advertisement and promotion of the SEF. The student, the student’s parents, and/or guardian agree to hold the SEF harmless from SEF’s use of any of the personal information referred to herein and furthermore agrees not to file any claim, action or suit against SEF for any use of personal information by any third party were such use has been permitted by the SEF. All applications will first be screened on the basis of leadership responsibilities in community activities and school activities and on grade point average. Scholarship applications will be scored in the following categories: Completeness of Application, Transcript, School / Community Activities to include leadership and honors and awards, Financial Need, and Essay Recommendations will be used in the event of a tie when scholarship recipients are being selected. SEF will have sole responsibility for the selection of recipients and its decision will be final. Recipients will be notified by mail. Student and Parent / Guardian Initial here: _____ _____ B. Recipients shall be responsible for any and all taxes. Recipients may be required to sign and return an Affidavit of Eligibility/Release of Liability. Student and Parent / Guardian Initial here: _____ _____ C. Any scholarship awards made relevant to this application expire on June 30, 2019. Any funds not used from this scholarship at that time will be returned to the general scholarship fund of the Suffolk Education Foundation, Inc. The SEF reserves the right to extend this deadline on a case by case basis, provided the recipient shows cause as to why the deadline should be extended. Student and Parent / Guardian Initial here: _____ _____ D. Students who receive a full scholarship are ineligible to receive funds from the Suffolk Education Foundation. If the student receives a full scholarship after an SEF scholarship is awarded, it is their responsibility to notify SEF immediately. Student and Parent / Guardian Initial here: _____ _____ E. The Suffolk Education Foundation may obtain a student transcript from your high school Guidance Office. Student and Parent / Guardian Initial here: _____ _____ 3

Suffolk Public Schools Student ID # _______________________ 5. CERTIFICATION In submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge. Falsification of information will result in termination of any scholarship granted. This application is the sole property of the Suffolk Education Foundation (SEF). Applicant’s Signature_____________________________________ Date__________ Parent/Guardian’s Signature___________________________ ____ Date__________ The deadline for completed applications is Wednesday, March 28, 2018. Application must be postmarked by midnight March 28, 2018.

Mail the completed application packet to: Suffolk Education Foundation PO Box394 Suffolk, Virginia 23439-0394 ATTN: Scholarship Committee Review the checklist of required items on Page 2. No incomplete or late applications will be considered.

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Suffolk Public Schools Student ID # _______________________

Scholarship application continued...SCORING OF APPLICATION BEGINS HERE

6. COLLEGE/POST SECONDARY STUDENT INFORMATION NAME OF COLLEGE OR ACCREDITED POSTSECONDARY EDUCATIONAL FACILITY YOU PLAN TO ATTEND: ______________________________________________________________________ CITY _____________________________ State ________________ Zip ___________

PLEASE CHECK WHICH APPLIES: 4 yr. College or University 2 yr. Community or Junior College Vocational/Technical School Other: please specify _______________________________________________ HAVE YOU BEEN ACCEPTED?

Yes*

No

*If yes, attach a copy of your acceptance letter or forward to the Foundation as soon as your acceptance is received

INTENDED MAJOR (please be specific)_____________________________________

CAREER GOALS: Describe your career goals in 7 to 10 WORDS on this page; only one answer: Please use words or phrases, not sentences or paragraphs. Examples … • Eliminate Elephant Poaching in Africa … • Reduce Infant Mortality by Researching Birth Defects … • Serve My Country as an Army Nurse … • Work with Cancer Victim Families to Find Community Support

______________________________________________________________________

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Suffolk Public Schools Student ID # _______________________ Scholarship application continued....

7. SCHOOL/COMMUNITY ACTIVITIES On a separate sheet with Student ID# at top - no name on page: • Type all school and community activities in which you have participated during High School (e.g. student government, music, sports, Big Brother/Big Sister, Youth Group, volunteer at nursing home, recycling project, etc.). • Indicate all special awards and honors. • List all leadership positions and offices held.

8. ESSAY Applicants must complete the following essay (minimum 500 word and 1,000 word maximum). Please type on a separate page with Student ID# at top of each page and attach all sheets to the application. What interested you in becoming a wrestler (please explain)? and What have you learned from wrestling that will benefit you in your future?

9. RECOMMENDATION LETTERS Two letters of recommendation addressing your school/community citizenship and potential success after further educational studies are required to be submitted with this application. •

One from a high school teacher, counselor, or administrator



One from your high school wrestling coach

This Scholarship is administered by the

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Doug Dohey Memorial Scholarship App-Final.pdf

Page 1 of 6. Doug Dohey Memorial Scholarship Application-2018. Administered by the Suffolk Education Foundation. Doug Dohey was raised in Forbes Road, PA and a graduate of Greensburg Salem High. School, Greensburg, PA, and California University of Pennsylvania, California, PA. Doug. answered the call to serve ...

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