100 Sherman Ave., Suite 3, Devens MA 01434 Scholarship Deadline: SCHOLARSHIP APPLICATION Must be postmarked by Friday, March 27, 2015 Today’s Date: ___________________ IMPORTANT: TYPE OR PRINT CLEARLY Student Name (Last, First, Middle): ___________________________________________________________________________ Social Security Number: __________________________________________ Gender: Male or Female (please circle one) Permanent Home Address: __________________________________________________________________________________ (Street) (City) (State) (Zip) Email Address: __________________________________________ Home or Cell Phone: _______________________________ High School: _____________________________________ Guidance Counselor’s Name: _______________________________ _________________________________________________________________________________________________________ Are you involved in any co-curricular program? Yes / No If so, what? ____________________________________________ Colleges you’ve been accepted to or are planning to attend: ____________________________________________________ _______________________________________________________________________________________________________ Anticipated date of College Graduation (Month/Year): __________________ Major: ___________________________________ List and explain your involvement in student life: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Describe any community service program or volunteer work in which you have participated, including a specific number of hours if you know them: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Briefly describe your career/professional goals: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ List and/or explain any Honors or Special Recognition received: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________  On a separate sheet, in 300 words or less, please answer the following question: How do you think that you, as a future business leader could improve the quality of life in the community?  Please provide two letters of recommendation (one from a member of your High School faculty). List the names and titles of the two recommendations attached: 1. ________________________________________________ (member of High School faculty) 2. ________________________________________________  Please include a copy of your academic transcript for the purpose of reviewing scholarship eligibility Student Signature: ________________________________________________________ Date: _______________________ Print Student Name: _______________________________________________________ Submit this application, your essay, and two letters of recommendation to the NVCoC Scholarship Committee, 100 Sherman Ave., Suite 3, Devens MA 01434. Note: Completing this application does not guarantee you a scholarship. Scholarships are awarded based on the specified criteria. You will be notified if you have been selected to receive this scholarship. Incomplete scholarship packets will not be considered. For Office Use Only: Received: ____________  Essay  Academic Transcript By: __________________  2 Letters of Reference  App Complete Notes: __________________________________________________________________ ________________________________________________________________________ Premier Sponsor