ÐÏà¡±á>þÿ =?þÿÿÿ:;<ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥ÁO ø¿P4bjbj ¼ ¼ ‰¢ÂÖ…eÂÖ…eÑ+~ÿÿÿÿÿÿ·Î Î $ÿÿÿÿ777P‡¬37Á?Ò?ô3III!!"C!W!@?B?B?B?B?B?B?$“B¶IEÀf?P"ÿ "!!P"P"f?II¶{?œ%œ%œ%P"RIIÐ=pœ%P"@?œ%œ%R¾5îœ:Iÿÿÿÿ0Ù¸s¯5Ôÿÿÿÿ¢"š¬9¼=‘?0Á?Ê9Ò F<#N F<œ: Fœ: c!"…!œ%!±!Ÿc!c!c!f?f?Š$c!c!c!Á?P"P"P"P"ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ Fc!c!c!c!c!c!c!c!c!Î Ù: United States JCI Senate Foundation Scholarship Application Eligibility: Graduating high school seniors in the United States, where that state has an active JCI Senate program (see HYPERLINK "http://www.usjcisentate.org" www.usjcisenate.org [under scholarship] or HYPERLINK "http://www.usjcisenatefoundation.org" www.usjcisenatefoundation.org for a listing of eligible states). You must be a U.S. citizen to apply for this scholarship. This package contains information and directions for applying to the United States JCI Senate Foundation Scholarship Program. Each year (April) $1,000 grants will be awarded to graduating high school seniors in the United States, who plan to continue their education at accredited post-secondary colleges, universities or vocational schools. The number of grants awarded annually will be at the discretion of the United States JCI Senate Foundation. They must be used for educational expenses in the first year of full-time study. Checks awarded will be made out in the name of the recipient and the educational institution of their choice. Instructions for applying for the US JCI Senate Foundation Scholarship Please read the following points carefully. Failure to comply will be cause for disqualification. Submission preference will be in a Microsoft Word compatible format. Typed or neatly hand printed (blue or black ink only) submission will also be accepted. Included in this application package are all the necessary forms. Your application packet pages must be submitted in order as listed below. Failure to comply will be cause for disqualification. Applicant Information High School Contacts College Information Parent or Guardian Information Financial Statement Leadership Positions & Offices / Memberships / Honors and Awards You may include additional sheets to continue the information for these areas as needed Employment Personal Statement (100 to 300 words) Continuation Pages for section 6-9 (if applicable) College or University Acceptance Letter (if applicable) Supporting documentation of your choice (awards, certificates, articles, pictures, etc) Reference Letters Transcripts (grades and state test scores) Signature Your personal statement is limited to 300 words. Any more than 300 words will not be judged. Reference letters are limited to three (3) letters with a maximum length of one (1) page (one side only) each. You will receive credit for each reference letter included. Your school transcript should be the very last attachment to your application package. Sign the bottom of the Personal Statement section Your name must be on the top of each sheet in the package, along with a page number. When using a MS-Word compatible editor, enter you name in the ‘Header’ section. Each student must have an active, working email address listed. PLEASE PRINT. All materials MUST be submitted under one cover. Materials sent in multiple mailings will NOT be accepted. Your application must be postmarked no later than January 11, 2019 to the State Scholarship Chairman listed under your state. NO electronic submissions will be accepted. Your application will be evaluated by persons outside of your area so do not use acronyms for items such as; clubs, programs, event, or awards where they are not national programs. Where the name of the item is not self explanatory, include a description. Example: REACH or J. Doe Memorial Award, should include a description such as: St. Thomas Methodist REACH program to feed the homeless, J. Doe Memorial Award for Top Female Tennis player. Do not include these first two pages of instructions in your reply. By submitting your application you agree that your name may be used as part of the public relations of the US JCI Senate program, the US JCI Senate Foundation and the US Junior Chamber of Commerce and their affiliates such as their associated state programs. To submit your application package: Refer to the website HYPERLINK "http://www.usjcisenate.org" www.usjcisenate.org or HYPERLINK "http://www.usjcisenatefoundation.org" www.usjcisenatefoundation.org, under the Scholarship section. Locate the state where you live. The due date is postmarked January 11, 2019. If your state is not listed, you are not eligible. Do not submit the application to any address on the web page except those under the State Scholarship listing section (packages submitted to the wrong address will not be forwarded). No electronic submissions will be accepted. United States JCI Senate Foundation Scholarship Application 1. Applicant Information Applicant NameDate of ApplicationApplicant Home AddressApplicant e-mail addressCityStateZip CodePhone NumberAre you a U.S. Citizen (check one) FORMCHECKBOX Yes FORMCHECKBOX No 2. High School InformationName of applicants High SchoolPrincipal or Counselor Name Address & CityStateZip CodePhone Number High School E-mail contact 3. College Information Name of College or University you plan to attend Address City State Zip Code Have you been accepted to this College or University FORMCHECKBOX Yes (if Yes, attach copy of acceptance letter) FORMCHECKBOX No 4. Parent or Guardian InformationFather’s NameCheck here if father is deceased FORMCHECKBOX Father’s Home AddressOccupationCityStateZip CodePhone Number Mother’s NameCheck here if mother is deceased FORMCHECKBOX Mother’s Home Address Occupation Check here if Mother is deceased City State Zip Code Phone Number Do you have a Step-Parent or Guardian other than your Parents: FORMCHECKBOX Yes FORMCHECKBOX NoIf YES, provide the following informationStep Parent or Guardian NameHome AddressOccupationCityStateZip CodePhone NumberList in chronological order the names of your brothers, sisters or other persons dependent upon your parents for supportNameAgeRelationship 5. Applicant’s Financial Statement Information The financial contribution of the applicant toward their own education is an important consideration in awarding this scholarship. The committee does not wish to penalize those students whose industry and careful planning have been a consideration in planning college attendance. The budget should be based on your first year of education. Your budget does not have to balance.Income1. Savings to date1. =SUM(right) \# "$#,##0.00" 2. Expected summer earnings2.3. Expected contribution from parents3.4. Earnings from part-time work4. =SUM(right) \# "$#,##0.00;($#,##0.00)" 5. Money from other sources: Include gifts from friends, relatives Education insurance, loans, other Scholarships. Etc. 5. Total Estimated IncomeExpenses1. Tuition and Incidental Fees1.2. room and Board2. 3. Books and Supplies3.4. Clothing4.5. Incidental Expenses (Travel, Recreation) 5. Total Estimated ExpensesExplain any special personal family or financial situation you believe merits consideration: 6. Leadership Positions and Offices List by name and by year (9, 10, 11,12) leadership positions and offices held, and the approximate time commitment each month for school, church, community and volunteer activities. Example: School: Student Council President (12; 2.7 hours/month) ; Yearbook Editor (12; 35 hours/month) ; Basketball Captain ( 12; 5 hours/month); Church: Youth Group President (11; 10 hours/month); Community: Hospital Volunteer Coordinator (11, 12 ; 25 hours/month)7. MembershipsList by name and by year memberships and other participation and the approximate time commitment each month for school, church, community and volunteer activities. Example: School: Basketball Team (9, 10, 11; 35 hours/month); Cheerleader (11, 12; 20 hours/month) ; 4-H Club (9, 10, 11, 12: 8 hours/month); Church: Youth Choir (10-12; 4 hours/month); Community: Hospital volunteer (9, 10; 25 hours/month) 8. Honors and AwardsList by name and by year the honors and awards you have received during high school. Example: School: 4-H Gardener of the Year (11); Boys/Girls State (11); National Merit Scholar (12) ; National Honor Society (12) Church: Perfect Attendance (9); Community: Hospital Volunteer of the Year (11) 9. EmploymentList the names and addresses of employers, including family business or self-employment. Indicate whether you worked part-time, during the summer, or full-time: and include the hours you worked on a monthly basis. Example: Mowing Lawns – Summer – 100 hrs. total (9); Wal-Mart – Part-time – 80 hrs. (10); Family Farm – Full-time – 160-hrs (11-12) 10.Personal StatementWrite (type or print) a paragraph of 100 to 300 words maximum, indicating your chosen field of college study. State your reasons for this choice. Include pertinent experiences, activities and accomplishments. Sections 11-15 shows the order to list your attached documents. Ensure to sign section 16 11. Continuation Pages from section 6-9 (if applicable) 12. College or University Acceptance letter (if applicable)13. Supporting documentation of your choice (awards, certificates, articles, pictures, etc.)14. References LettersYou may include up to three (3) letters of reference from educators, clergy, employers, and/or community leaders. References should be attached to this application. 15. TranscriptsA copy of your current high school transcript MUST be included. This MUST include class scores and state test scores (state test scores are not required if home schooled). If you are taking college classes, include those as well. 16. Signature I certify that the facts contained in this scholarship application are true and correct. The United States JCI Senate Foundation is hereby authorized to verify any information contained in this application. I understand that any falsification of misrepresentation will result in disqualification. Signature of applicantDate Signed Staple all pages together in the upper left-hand corner. Be sure you include all references and other attachments. Each page of your application MUST list your name and list the page number in the upper right-hand corner. Remember to sign the application package (above) To submit your application package: Refer to the website HYPERLINK "http://www.usjcisenate.org" www.usjcisenate.org or HYPERLINK "http://www.usjcisenatefoundation.org" www.usjcisenatefoundation.org, under the Scholarship section. Locate the state and submission address of the state you live. If your state is not listed you are not eligible. Do not submit the application to any address on the web page except those under the State Scholarship listing section (packages submitted to the wrong address will not be forwarded). 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