JAX CHAMBER WEST COUNCIL SCHOLARSHIP APPLICATION

The West Council of the Jax Chamber is pleased to offer a $1,000 college scholarship to a deserving high school student for the 2013-2014 school year! In order to qualify for the scholarship, there are only a few requirements: You must have a connection to the Westside of Jacksonville: either you live on the Westside, you go to school on the Westside, or one of your parents works on the Westside. You must have a cumulative high school GPA of at least 3.0. You must be enrolled to attend an accredited two- or four-year college in the fall of 2013. You must complete this application in full, including a one-page essay about why you should be awarded the scholarship. The application must be completed in this Word format (take as much room as you like to answer) and emailed to Ruth Ann Hepler at ruthannhepler@gmail.com by June 7, 2013. If you are selected, you must provide your high school transcript (or other proof of your graduation/GPA), proof of your SAT/ACT score(s), and proof of your college acceptance. In addition, you must attend the West Council lunch at the Florida Yacht Club on Friday, July 19, 2013, to meet the members, introduce yourself, and tell us about your college plans.

The scholarship will be awarded in two parts: $500 for the fall semester and $500 for the spring semester. In order to receive the spring semester award, you will need to provide proof that you earned at least a 2.5 GPA for the fall semester and that you completed at least 12 semester hours. The money will be deposited into the students account at the college. The 2013-2014 scholarship winner will be given priority consideration to renew the scholarship for the following three years.
Name DOB Address Phone # Email address Total Family Income for 2012: __less than $20,000 _ $20,000-$40,000 __$60,000-$80,000 __$40,000-$60,000 Alternate Phone # Age

__$80,000-$100,000 __$100,000+

Number of Family Members Living at Home: ____Mother ____Father ____Brother(s) ____Sister(s) ____Other Relative(s)

Ages of Siblings: Number of Dependents in the Family: Number of Dependents Currently in College: Parent(s) Place of Employment (including address): Name of High School : High School GPA: Highest SAT score: Highest ACT score: Name of College You Will Attend in the Fall (full name and location): How do you intend to pay for college? Extracurricular Activities, Honors, Community Service, etc.: Other Scholarships You Have Received and Amount(s): How did you hear about this scholarship opportunity? In one page or less, tell the West Council why you deserve this scholarship.