THE ANITA PRIEST


MEMORIAL SCHOLARSHIP FOUNDATION


 

 

 
Scholarship Application
 
 

 

ANITA PRIEST MEMORIAL
SCHOLARSHIP APPLICATION

Overview of Application
(click here to download actual Application PDF format)

 


All information is strictly confidential. This authorization is being granted to this Committee as it pertains to being considered for the Anita Priest Memorial Scholarship.

Eligibility: You must be a resident of South Florida.

Instructions: You must follow all instructions for your application to be considered. See the checklist below before sending the application via e-mail. Applications must be complete before they will be considered.

• Completed and signed application
• Recent photo or digital photo in jpg, gif, or bmp format
• Most recent academic transcript to be sent by the school by e-mail or by mail directly to Cecile Hatfield at cecilehatf@aol.com or 1556 N.E. Quayside Terrace, Miami, Florida, 33138
• At least two and no more than three letters of recommendation (At least one of these must be from an individual familiar with your work in South Florida (no family members)
• A scan of Driver’s License / State Issued ID


I authorize the Anita Priest Scholarship Committee to review and discuss my grades and other records concerning me that are maintained by my school or submitted by me for consideration. This authorization is being granted to this Committee as it pertains to my being considered for a Scholarship Award.

Student’s Authorization Yes No
First Name: Last Name:
Address:
City: State: Zip:
E-mail: Tel:

1. Are you a graduating high school senior? Yes No
2. Date of Birth: 3. Ethnicity/Race:
4. Are you a member of the LGBT community? Yes No
5. If yes, are you “out and open” in the community? Yes No
6. Are you a supporter of the gay community? Yes No


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APPLICANT’S ACADEMIC STATUS (Skip to question 14 if you are a graduated high school student)

7. Name of High School: Phone:
Address: City: State: Zip:
8. Name of Financial Aid Advisor: Phone:
9. Name of Principal: Phone:
10. Are you in a good academic standing? Yes No
11. GPA Approximate Class Rank Number in Class
12. Have you been awarded any school honors or recognitions? Yes No
If so, please list them

13. What school clubs or extracurricular activities are you involved with?

APPLICANT’S FINANCIAL NEEDS AND COLLEGE INFORMATION
14. Are your parents aware of your gay status? Yes No
15. Are your parents supportive of your gay status? Yes No
16. Do you live apart from your family? Yes No
17. Do you support yourself financially? Yes No
18. Do you believe that you have any special needs? Yes No
If yes, please explain your needs on a separate sheet of paper. These special needs will be treated with confidentiality. If we need to contact anyone else about these needs, we will contact you first to obtain your permission to talk with others about your needs
19. To what colleges are you applying:
If you are currently in college, what is the name of your current institution and what is the cumulative GPA (grade point average)?
20. What is your admission status? Planning to apply
Waiting for school to respond
Admitted
21. Estimated annual college cost (tuition, room and board, books, etc.)$
22. Do you have a chosen major? Yes No
If yes, list chosen major:
23. How do you plan to finance your college education? (check all that apply)
Grants/Scholarships College Work/Study Program
Part-Time Employment Full-Time Employment
Student Loans
24. Are your parents able and willing to assist with your college expenses?
Yes No

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IF YOUR PARENT(S) ARE SUPPORTIVE, AND WILLING AND ABLE TO ASSIST WITH YOUR COLLEGE EXPENSES, PLEASE ANSWER THE FOLLOWING QUESTIONS (skip to question 30 if this does not apply to you)

25. Is this a single-parent family? Yes No
1st Parent’s Name:
2nd Parent’s Name:
26. If both parents reside at the same address, are they both working?
Yes No N/A
27. Total household income as reported on most recent federal tax return(s):
$
28. Number of dependent children in the household:
29. Number of dependent children in college :

APPLICANT’S COMMUNITY SERVIVE INVOLVEMENT AND/OR ANY EMPLOYMENT HISTORY

30. Please briefly describe any community service activities with which you have been involved. You should describe only those activities which have been of the highest importance to you. You do not have to describe every activity that you have undertaken. Be sure to mention any activities in which you have played a leadership role in ANY activities in the gay community.



31. What jobs, if any, have you held? Please list both volunteer and paid positions as appropriate.

Employer’s Name:
Job Title: Date of Employment:

Employer’s Name:
Job Title: Date of Employment:

Employer’s Name:
Job Title: Date of Employment:

32. Please describe any achievements of which you are especially proud:

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ESSAY QUESTIONS

1. What career do you plan to pursue upon completion of your education? How have your past experiences shaped this goal? (500 word limit)

4. If applicable, how has the fact that you are gay, bisexual, or transgender affected your life? How would being a recipient of this scholarship allow you to make a positive contribution to the gay community? (400 word limit)

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3. Optional Essay: Complete this essay if there is other information you would like to add regarding your candidacy. For instance, if you believe one or more aspects of your application (e.g., GPA or test scores) do(es) not accurately reflect your potential for success, please elaborate. (300 word limit)

CERTIFICATION:

I attest that all the information contained in my application is factually correct and honestly presented. The Anita Priest Scholarship has my permission to verity information submitted in this application. I understand that any misrepresentation of my application will justify the denial or cancellation of any offer of scholarship by the Anita Priest Scholarship.

Yes No Date:
Name/Signature
Typing your name above
reflects a valid signature

(click here to download actual Application PDF format)

Mail Application to:

SANDRA HOLIDAY
20301 West Country Club Drive
Suite 2124
Aventura, Fl. 33180

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