GFA Scholarship Application Requirements: BE SURE TO COMPLETE ALL 10!

  1. Eligibility for the scholarship is based on active membership or being the son or daughter of an active member. Membership applications are available in our quarterly Bulletins or on our website, www.griswoldfamily.org.
  2. Applications pending or acceptance at one or more accredited undergraduate educational institutions. Students applying to or enrolled in graduate school are not eligible to apply. Students must be taking at least nine credit hours each semester or quarter (“3/4 time”).
  3. Three-page scholarship application submitted. The applicant must show that financial aid would be helpful and will be required to submit Part Il – Financial Data of the application.
  4. Work experience.
  5. Membership in organizations.
  6. Aspirations for the future.
  7. Personal circumstances, if warranted.
  8. Transcript of grades, from college or high school, submitted with application or sent by school
  9. Topical theme essay: using not more than two double-spaced, typed pages, write an essay on the following: Tell us about the achievements of one of your Griswold ancestors (does not need to be named Griswold). Use two double-space pages for your essay, (digital format preferred)
  10. Required creative assignment: use your imagination to picture (words or drawing) a typical 17th century Griswold household (people, location, activities). Digital format preferred

GRISWOLD FAMILY ASSOCIATION SCHOLARSHIP PART I

Name of  GFA member: must be applicant or applicant’s parent

_______________________________________________________________________________

 

Griswold Line, if known (please circle one):           Edward    Michael            Matthew             Francis

APPLICANT  INFORMATION:  (Please print legibly)

Name _______________________________SSN or student number______________

Last               First                      M.I.

Home Mailing Address __________________________________________________________

Home Phone  (       )____________        Date of Birth _____     E-mail address______________

Father or Guardian Name ________________________________________________________

Mother or Guardian Name _______________________________________________________

 

  1. U. S. Citizen? Yes _______ No __________

 

  1. High School(s) Attended? ______________________________________________________

______________________________________________________

  1. High School Graduation Date ____________________

 

  1. Institution of higher learning to which applicant’s scholarship award is requested (if known; we recognize that some have college applications pending on admission results):

Institution                                Location                                Major

______________________________________________________________________

 

  1. Will you commute from home? ___ Live on Campus? ___ Off-campus apartment?________

Part I continued

  1. Parent’s or Guardian’s occupation:

Occupation                                 Employer

Father ___________________       __________________________________________

Mother __________________        __________________________________________

  1. Other family members in same household:

Relationship                                Age                                       Status (Employed-student-etc.)

______________________________________________________________________________

______________________________________________________________________________

  1. Other scholarships, grants, loans, etc. you are seeking or have received:

Source                Amount Sought                          Amount Received

_____________________________________________________________________________

_____________________________________________________________________________

PLEASE COMPLETE IN DETAIL THE FOLLOWING QUESTIONS. ATTACH ADDITIONAL SHEETS OF PAPER FOR COMPLETE ANSWERS AND IDENTIFY WITH APPROPRIATE LETTERS:

  1. Describe your work experience, indicating period of time in each job, rates of pay, and duties/responsibilities.
  2. List your memberships and participation in school and community organizations and activities.
  3. Prepare a statement of your aspirations, and give other information you feel will help the award selection committee.
  4. Indicate unusual family or personal circumstances, if any, which you feel warrant the attention of the award selection committee.

I hereby give permission to my high school to release a copy of my transcripts of grades, class rank, college board scores. I further certify that the information contained in this application is complete and accurate, to the best of my knowledge.   Applicant’s signature ______________________________

TO THE APPLICANT’S HIGH SCHOOL COUNSELOR (if applicable): Please attach comments about any unusual factors which you feel warrant special attention, and attach applicant’s class rank, college board scores, and official transcript.   Counselor’s Signature ____________________________

Applicant Name ____________________________________________________

Part Il – Financial data to be completed by parent or guardian (if applicant is a dependent)

 

Please take the information from your most recently completed IRS income tax return

Taxable Income:  Father                                               ___________

Mother                                             ___________

Applicant                                           ____________

 

Number of dependents on parent’s tax return        ___________________ (indicate if filing separately)

 

Applicant’s parents’ marital status is ___ married____ single___ divorced_______ widowed_______

 

Total of family members who will be attending post-secondary school at least half-time during the next school year (include applicant) _____________________________________

 

Part III – Certification and Signatures

Certification:
All of the information on this form is true and complete to the best of my (our) knowledge. If asked by an authorized official, I (we) agree to provide proof of the information I (we) have given on this form. I (we) realize that this proof may include a certified copy of my (our) U. S. Income Tax Return. I (we) also realize that if I (we) do not provide such proof if asked, the applicant may not receive scholarship aid.

Signatures:

Applicant _________________

 

Parent/Guardian ___________________

 

Date ___________________