Henry Street Settlement Youth Scholarship

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Section 5 Work/Volunteering Experience: (Please type in responses or use an additional piece of paper to complete your answers.) Describe your work and/or volunteering experience. Indicate dates of employment for each job and approximate number of hours worked each week. Employer/Volunteering Site Position Duration Hrs/Wk How have these positions affected your personal and professional development? Do you plan on working during the summer? If so, where? Section 6 Financial Data: Will you be receiving any other scholarship or grant monies? If so, from where and for how much? How much is your tuition? Scholarship amount requesting? How many members of your household will be in college? (Include yourself) Please explain the intended use for your scholarship money. Be Specific. Use an additional sheet of paper if necessary. Section 7 Essay: On a separate piece of paper, type a 250-500 word personal statement (one to two pages) explaining your future goals as they relate to your education and why you should be chosen to receive this scholarship. 6
Application Check List: Before you hand in your application, please be sure that you have completed and included the following! Scholarship Application (All 3 pages should be completely and neatly filled out) Student Evaluation Form (The only form that doesn’t have to be typed) Copy of Current Transcripts (A unofficial copy is fine) FAFSA Student Aid Report (SAR) with your Expected Family Contribution (EFC) (This can be obtained online @ www.fafsa.ed.gov) Financial Aid Award Letter from your intended college/university and Copy of Acceptance Letter (A current bill can replace a Fin.Aid award letter and a letter confirming attendance from the registrar can be accepted from current college students) Essay (12 font, Time New Roman, Double Spaced ONLY – NO COURIER NEW!) READ, SIGN, AND UNDERSTAND THE TERMS IN THE STUDENT PLEDGE. Student Pledge: In submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge. I understand that falsification of information will result in termination of any scholarship granted. If granted scholarship money, I will use the funds I have requested for the purpose stated previously in this application. I AGREE TO PROVIDE THE EXPANDED HORIZONS PROGRAM COORDINATOR A PROGRESS LETTER AT THE END OF EACH SEMESTER I COMPLETE THIS YEAR, APPROXIMATELY DEC. 5 TH AND APRIL 5 TH . This progress letter will include a brief description of how my semester went, classes taken, grades received, clubs, sports, or organizations in which I participated, my proudest achievement for the semester, and my plans for the summer and/or the next school year. I understand that my award will be distributed in two installments and those installments will not be distributed until all documentation and/or progress letters are received. In the event that I cannot attend school, I will immediately notify Henry Street Settlement and return the scholarship check. Student Signature Legal Guardian’s Signature Date Date 7
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Henry Street Settlement Youth Scholarship

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