Irelands Scholarship

It's Ireland Scholarship time. Attached is the application form. Please use this copy...it has a couple changes on it from last year. And do read the first page with the qualifications/procedures listed. The Irelands truly wanted to help students who need the financial assistance to attain their goals.

Let me review the intentions for the A.G. & Rosalee Ireland Scholarship...

• The scholarships will be awarded to those individuals pursuing their post high school education at a non-profit organization, including bible colleges, accredited colleges or universities and accredited technical institutions.

• This scholarship is for students not necessarily at the top of their class, but someone you feel has the potential to succeed at a higher education institution. They may be just "hitting their stride" or realizing their future plans as they experience their senior year.

• The total amount to be awarded is $1,000 each.

• You may submit as many applicants as you wish. They will join a pool of applications from other Woodbury County schools, South Sioux City Schools, alternates from the Sioux City Schools, and applicants from previous years.

• Please note the due date is April 13.

• Please send the student's application to me via U.S. mail or Media Van using the following address...

Northwest AEA

Penni Kistner

Attn: Jill Helm

1520 Morningside Ave

Sioux City, IA 51106

Applications will be read and scholarships awarded following the April 13th due date and you will be notified in time for your awards programs.

APPLICATION FOR A.G. AND ROSALEE IRELAND SCHOLARSHIP

QUALIFICATIONS & PROCEDURES

1. The amount of scholarship funds available each year will be determined by the Trustee.

2. The number of scholarships awarded each year will be determined by the Trustee.

3. The recipients will be determined annually by the Directors of the Fund.

4. The applicant must be a high school graduating senior or a full time college student who received the scholarship the prior year.

5. The applicant must attach a current transcript.

6. The applicant must attach a typed Personal Statement as to why they deserve this scholarship, including future educational plans and goals.

7. The application must be completed in full.

8. Each scholarship is granted for a period of one year.

9. The recipients will be those students who want to pursue post high school education, but who may not otherwise be able to continue their education without financial assistance.

10. Selection of recipients shall be made without regard to race, color, religion, sex or place of residence of the recipients.

11. Full payment will be paid directly to the institute of higher learning upon confirmation and proof of registration as a full time student at the fall semester. Failure to notify the Trustee of registration as a full time student by December 1st will result in forfeiture of the Scholarship.

Signature _________________________ Date _________________________

RETURN THIS COMPLETED SCHOLARSHIP APPLICATION TO YOUR HIGH SCHOOL COUNSELOR BY: April 13, 2012

NAME: ____________________ ____________________ ____________________

(First) (Middle) (Last)

HIGH SCHOOL ATTENDING/ATTENDED: ________________________________________________

HOME ADDRESS: _____________________________________________________________________

(Street) (City/Town) (Zip Code)

PHONE NUMBER: ___________________ SOCIAL SECURITY NUMBER: ____________________

NAME OF COLLEGE/UNIVERSITY I PLAN TO ATTEND: ___________________________________

ADDRESS: ___________________________________________________________________________

(Street) (City/Town) (State) (Zip Code)

PLEASE NOTE IF ALREADY ATTENDING: _______________________________________________

HOUSING FOR COMING SCHOOL YEAR: ___ON CAMPUS___WITH PARENTS___OFF CAMPUS

MAJOR AREA (S) OF STUDY: __________________________________________________________

_____________________________________________________________________________________

CAREER GOALS: _____________________________________________________________________

_____________________________________________________________________________________

NAME OF FATHER (IF LIVING): ________________________________________________________

OCCUPATION: ____________________________ EMPLOYER: _____________________________

NAME OF MOTHER (IF LIVING): _______________________________________________________

OCCUPATION: ____________________________ EMPLOYER: _____________________________

WILL YOU BE A CANDIDATE FOR FINANCIAL AID? _____ YES _____ NO

IF NO, PLEASE EXPLAIN: ______________________________________________________________

PERSONAL STATEMENT ANY INFORMATION TO HELP US DIFFERENTIATE FROM OTHER STUDENTS (PLEASE TYPE AND ATTACH):

· WHY I BELIEVE I QUALIFY FOR THE SCHOLARSHIP

· MY EDUCATIONAL FUTURE PLANS AND GOALS

ACADEMIC DATA

I presently rank _____ in a class of _____ students. (7 semesters)

My cumulative grade point average is __________.

ACT

Eng Math Reading Sci Comp

Standard Scores

National Percentiles

OR

SAT

Verbal Math

Current Score

College Bound Percentile

EXTRACURRICULAR ACTIVITIES

Please list your primary extracurricular, community and family activities and hobbies. Include specific events and/or major accomplishments. You may attach an extra document.

WORK EXPERIENCE

Please list any job (including summer employment) you have held during high school.

REFERENCE

Please have a teacher or employer fill out reference form and attach to your application.

Compared to other college or college/bound students, check how you would rate this student in terms of academic skills, potential and work ethic:

Comments: ____________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Signature of Evaluator: ___________________________ Date: _______________________

Position: _______________________________

SCHOLARSHIP FINANCIAL INFORMATION

Important: Please fill out entire section to the best of your knowledge

Who will pay for college tuition and other expenses? _____ Student _____ Parent

_____ Both _____ Other (please explain)

If Student is paying any expenses, please indicate approximate totals:

Annual Income from Student’s Employment: $ _______________________________________

ASSETS LIABILITIES

Checking/Savings $________________ Current Loans/Debts $_______________

Other Investments $ _______________ Other $ ___________________________

Other (give source) $ _______________

TOTAL: $ _______________________ TOTAL: $ ________________________

If Parents are paying any expenses, please indicate approximate totals:

Annual Income from Father’s Employment: $ ________________________________________

Annual Income from Mother’s Employment: $ _______________________________________

ASSETS LIABILITIES

Checking/Savings $________________ Current Loans/Debts $_______________

Other Investments $ _______________ Other $ ___________________________

Home Value (if owned): $ ___________

Other (give source) $ _______________

TOTAL: $ _______________________ TOTAL: $ ________________________

Did Student qualify for any of the following? If so, please give approximate amount:

Private Loans $ ___________________

Scholarship(s) $ __________________

Grants $ ________________________

Other (give source) $ _______________

TOTAL: $ _______________________