BRUCE CAMPBELL SCHOLARSHIP AWARD

2009 AWARD NOMINATION

 

 

 

1.     The scholarship is for a maximum of $3,000.00.

2.     The applicant must be a NECCD member, for at least 2 yrs prior, or member of the immediate family.

3.     The applicant’s 2009 membership dues must be paid prior to September 1, 2009.

4.     The applicant must be matriculating in a recognized institution of higher learning with a degree path.  Undergraduate degrees only.

5.     The 26th ANNUAL scholarship will be awarded during the 70th Annual Training Institute at the Sea Crest Oceanfront Resort in North Falmouth, Massachusetts.

 

The following is required in order for your application to even be considered:

1-  Current transcripts (from the past school year)

2-  A copy of an acceptance letter (if applicable)

3-  2 reference letters ** One must be a teacher (from within 1 year) and the second can be a personal reference (no relatives)

4-  Statement of Purpose

 

Completed Applications must be postmarked NO LATER THAN AUGUST 10, 2009 and mailed to:

                             Shawna Lapierre, Chairperson

                             Hillsborough County Reentry Program

                             300 Hanover St., Manchester, NH 03104

                             Phone: (603) 665-1551, Fax: (603) 665-1575

                             E-mail: Shawna.R.Lapierre@nhes.nh.gov

 

 

 

 

 

 

 

 

 

I, _______________________, have read the requirements made by NECCD for the Bruce Campbell Scholarship Award.  By signing below I am indicating that I have enclosed ALL required materials as outlined above.

 

 

____________________________________________________ Date:______________

Applicant Signature

 

 

This sheet must be included for your application to be considered. Please staple it to the top of your application package.

 

I hereby make application for the 2009 scholarship from the NECCD Scholarship Committee: 

(please type or print information)

 

____________________________________________________________________________________________________________

LAST NAME                                                                                        FIRST                                    MI                                           DOB

 

____________________________________________________________________________________________________________

ADDRESS                                                            CITY                                      STATE                                   PHONE #

 

____________________________________________________________________________________________________________

NAME, ADDRESS, & PHONE OF NECCD MEMBER AND RELATIONSHIP TO APPLICANT

 

____________________________________________________________________________________________________________

 

 

Have your applications been accepted? ____________.  If yes, please submit a copy of acceptance letter(s).

                                                                                                 (Yes/No)

 

 

 

 

 

 

 

 

 

 

 

 

 

Estimated college cost per year:                               Other sources of aid:

A.  Tuition                    $________                              A.  Student’s savings for education        $_________

B.  Room & Board       $________                              B.  Loans                                             $_________

C.  Books & Supplies   $________                              C.  Parents/Relatives                             $_________

D.  Misc. Fees              $________                              D.  Other scholarships                          $_________

            TOTAL:          $________                              E.  Other sources                                  $_________

                                                                                           (Insurances, trust funds, etc.)          $_________

                                                                                                            TOTAL:                      $_________

 

Father’s Name:  ___________________________  Mother’s Name:  _______________________________

Occupation:  ______________________________   Occupation:  ___________________________________

 

 

Father’s Income:  (please check only one)                  Mother’s Income:  (please check only one)

            Unemployed                 ______                                    Unemployed                 ______

            Under $15,000             ______                                    Under $15,000             ______

            $15,000 – 20,000        ______                                    $15,000 – 20,000        ______

            $20,000 – 25,000        ______                                    $20,000 – 25,000        ______

            $25,000 – 30,000        ______                                    $25,000 – 30,000        ______

            $30,000 – 40,000        ______                                    $30,000 – 40,000        ______

            $40,000 – 50,000        ______                                    $40,000 – 50,000        ______

            $50,000 – 75,000        ______                                    $50,000 – 75,000        ______

            Over $75,000              ______                                    Over $75,000              ______

 

Are you living with mother ______ , father ______ , both ______ , or other ________?  If other, please specify.

 

Number of siblings:  ______              Ages:  ______________________________________________.

 

How may family members are in college now or will be within the next four years?  _____________

 

 

 

List all of your activities in school, church, or community during the past four years of school and the years of participation in each activity:

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

 

 

List any work experiences (part-time, after school, and/or summer):

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

 

List class offices, clubs or athletic activities involved with during last four years of school:

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

 

STATEMENT OF PURPOSE:  On a separate piece of paper in 300 words or less, write a concise and complete statement including the following:

 

A.                 reasons for your desire to continue your education

B.                 your educational objective

C.                 reasons you are entering a specific field or career

D.                 reasons for choosing this particular school

 

 

_______________________________________________              ___________________

 (Signature of student)                                                                                   (Date)                       

 

 

_______________________________________________              ___________________

 (Signature of parent)                                                                         (Date)