School Telephone: ... How many family members reside in your home: ______. Approximate cost to attend a college or unive
.. .. .. .. .
Gregory A. Hadley, Sr. Education Committee Chairman 61 Ives Street Waterbury, CT. 06704 203 – 768 – 2396
[email protected]
J & J Inc. Giving Back To The Community Scholarship Application Personal Information---Please Print/Type
Name: ______________________________________________________ First
Address:
Middle
Last
____________________________________________ ______________________________________________________________
Telephone (
) _______________________________________
Email address: __________________________________________ Date of Birth: Place of Birth:
______________________________ ______________________________
Current High School:
______________________________
School Telephone:
______________________________
Guidance Counselor:
______________________________
Colleges Applied to: 1. __________________ 2. __________________ 3. __________________ SAT Score: ____________
Accepted? Accepted? Accepted?
Yes ______ ______ ______
No _____ _____ _____
ACT Score: _________
Please list the extracurricular activities you are involved in (church, school, community) as well as any/ all academic and merit- based honors that you have received in the past two years.
............................
All Financial Information Required Yearly Household Income: _______________________________ (Documentation Required) How many family members reside in your home: _____________ Approximate cost to attend a college or university this year: Student Budget Tuition & Fees: Room & Board: Transportation: Personal Expenses: Other (Provide details):
Student Resources Parent Contribution: Student Contribution: Other: (Provide details)
TOTAL:
TOTAL: Parent/ Legal Guardian Information
Father/ Guardian: _________________________________ Home Address: _________________________________ Home telephone: _________________________________ Work telephone: _________________________________ Occupation: _________________________________ Employer: _________________________________ Employer’s Address: ____________________________ Mother/ Guardian: ________________________________ Home address: _________________________________ Home telephone: _________________________________ Work telephone: __________________________________ Occupation: __________________________________ Employer: __________________________________ Employer’s Address: _____________________________
All Financial Information Is Confidential &Secure
ESSAYS: You must provide the last four digits of your social security number on each essay instead of your name. Please type your essays on a separate piece of paper. You must select 2 essays listed below and submit a 500 word essay for each essay that you select. (Must Choose 2) 1. Please create a program or event that would be beneficial to giving back to the community. 2. Please name your role model(s) and the positive impact s/he has had on your life.
3. Please write a short essay on why you are the best candidate to receive financial assistance from J & J Inc.
APPLICATION DEADLINE: Friday, April 11, 2014 (must be postmarked by this date) Applications are to be addressed to; Gregory A. Hadley, Sr. J & J Inc, Education Committee Chairman 61 Ives Street Waterbury, CT 06704
J & J Inc. Scholarship requirements Eligibility Requirements: The deadline for this application is Friday, April 11, 2014 Incomplete applications or applications received after the deadline will not be reviewed. If there is not a clear postmark on your envelope the application will not be accepted. Applicants should have at least a 2.5 cumulative grade point average. Applicants must be a citizen of the United States. The applicant must also be planning on attending college or a university on a full time basis (12+ credits) Applicant must be African American. Applicant must have completed some form of community Service One graduating senior from each of the City of Waterbury high schools will be awarded a $500.00 each.
Application requirements: (if not provided, points will be deducted) Two letters of recommendation (one academic and one community service) Transcripts (photocopy of official transcript is acceptable) Brief statement stating educational objectives, career goals, financial need, past and current extracurricular activities (community involvement with emphasis on community service activities) and how this scholarship will help you reach your goals. Complete essay questions on the application w/ last four digits of social security number. A short (paragraph) biography must be submitted. A picture suitable for publication Please understand that neither your biography nor your picture will be returned.
Education Committee The education committee of J & J Inc. will screen the applications.
Scholarship Awards Scholarship awards are to be applied towards tuition, fees, books, supplies and/ or equipment required for the courses at the educational institution. Proof of acceptance and enrollment by an accredited college or university on a full time basis must be submitted prior to scholarship monies being disbursed.
