Fort Worth/Tarrant County A&M Mothers' Club

SCHOLARSHIP INFORMATION AND APPLICATION FORM

SCHOLARSHIPS

ELIGIBILITY

      OR

Note:  A high school or A&M college student or their parents/guardians must reside in Tarrant County or a surrounding County not currently represented by an A&M Mother’s Club or have graduated from a Tarrant County high school.

CHECK-OFF LIST

Incomplete packets cannot be considered.
If you want confirmation of receipt of your application, please include a self-addressed stamped envelope.
All questions shall be in writing (email preferred).  Emails should contain FWTC Scholarship in the subject line.

 

 


scholarshipapp

 

Fort Worth/Tarrant County Aggie Mothers’ Club
2010 Scholarship Application

 

Date:  ___________________________

PERSONAL INFORMATION

Name

Address                                                                                                                               City/State/Zip Code

Phone

 

Parents Name and Address

 

Siblings/Ages

U.S. Citizen
          YES      _______________

           NO       _______________

If not:
      PERMANENT RESIDENT?   _________________

      OBTAINING CITIZENSHIP?  _________________

 

EDUCATIONAL RECORD ............... Entering Freshmen Only Complete This Section

Present High School:

Graduation Date:

SAT Score

ACT Score

High School GPA

Class Rank

Class Size

Tentative College Major

 

Current A&M Students Complete This Section

A&M Cumulative GPA:

Class of:

Date Entered A&M

Expected Graduation Date:

Major:

Expected Degree:

A&M Address:

Street / P.O. Box                ___________________________________________________

City  /  State  / Zip Code     ___________________________________________________

Phone Number                    ___________________________________________________

 

Activities and Organizations

 

Please list 3 school and/or community extra-curricular activities.  Entering freshmen include from grades 9–12.  Current A&M students include college activities only.

Grade

Activity or Organization

Office and/or duties

1.

 

 

2.

 

 

3.

 

 

List Honors and/or Awards

 

 

Work Experience- Please include summer and part-time employment you have had during high school or college:

Position

Employer

Dates Employed

Hrs/Week

Total Earnings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please use one extra sheet of paper if necessary for the following 3 questions.(Please write name at top of page)

 

In what high school organization were you most active and what was your role within the organization?

What are your goals for the next 4 years, both academic and extra-curricular?

What do you plan to contribute to A&M (service, leadership, and spirit)?


 

Name

Social Security Number

FINANCIAL INFORMATION

THIS INFORMATION IS STRICTLY CONFIDENTIAL.  The committee reviewing these applications will not know the identity of the applicant.  Names, addresses, phone numbers, etc.  will be blacked out before the applications are given to the committee members.

Because this scholarship is partially based upon financial need, the following information will help the scholarship committee assess your financial situation. 

List any scholarships, grants that have already been awarded to you for the 2008-2009 academic year.  Current A&M students, list all scholarships, loans and grants presently held. 

Name

Amount

 

 

 

 

 

 

Returning students:  Have you ever received a Fort Worth/Tarrant County Aggie Mom scholarship?   Y / N

Father/Guardian

Mother/Guardian

Name:

 

Name:

Address:

 

Address:

Occupation/Employer:

 

Occupation/Employer:

 

Family Income Range:    ____ Under $19,999       _____ $20,000 – $39,999     _____ $40,000 – $59,999
(adjusted gross income
as reported to IRS)         ____ $60,000 – $79,999   _____ $ 80,000 – $99,999    _____  Over $100,000

Total Family Size:

Number of family members in college next year with enrollment of 12 or more hours (including yourself)

Are there any persons, other than your parents and yourself, who receive financial support from your family?

 

On an additional piece of paper, please list any other information that would be helpful in assessing your need for this scholarship.