Students

Michael Scott Kramer Memorial Scholarship Application

This scholarship is not available to members or relatives of the San Juan Island Community Foundation (SJICF) Board; Members or relatives of SJICF Scholarship Review Committees; SJICF employees and their relatives; and employees or family members of donors to the scholarship for which you are applying.

"*" indicates required fields

APPLICANT INFORMATION

First Name*

Last Name*

Middle Initial

Permanent Mailing Address*

Address Line 1 Address Line 2 City State ZIP Code

Phone*

Email*

Date of Birth*

Parent/Guardian Name(s)*

EDUCATIONAL BACKGROUND

Please provide details for any schooling or training you have already completed or expect to complete in the near future.

HIGH SCHOOL*

Graduation Date*

City & State*

Cumulative GPA*

COLLEGE

City & State

Cumulative GPA

Graduation Date

Major & Degree Received

TRAINING PROGRAM(S)

School/Program

Degree/Certificate

Completion Date

PROGRAM INFORMATION

What are your educational/training goals, and why have you chosen this area of study?*

Name of college, university, or educational program*

City & State*

Have you been accepted to this school/program?*

Yes

If no, please explain:

Intended major/focus*

What degree or certification do you expect to receive?*

What is your expected completion/graduation date? (MM/YY)*

Annual Cost: Tuition & Fees*

Annual Cost: Books & Supplies*

EXTRACURRICULARS & EMPLOYMENT

List

Please list your participation in extracurricular activities or volunteerism you have participated in, as well as any offices held or awards received. (Add rows if needed.)

Activity/Organization

Dates (From MM/YY - To MM/YY)

Offices Held/Awards/Honors

What was your most memorable community service experience & why?*

List

Please list any paid jobs you have held during the past two years. (Add rows if needed.)

Employer

Position

Dates (From MM/YY - To MM/YY)

VERIFICATION

The information included with my application is true and accurate in all respects, and I intend to pursue a degree in higher education. I understand that, if selected, the awarding of funds is contingent upon my enrollment in an accredited program, and that the funds will be paid directly to the institution and used toward the cost of my education. I authorize SJICF to share this information with SJICF staff and Scholarship Committee members. I authorize SJICF staff and Scholarship Committee members to contact school officials for additional information, if needed.

Verification Agreement*

I have read and agree to the above verification.

Signature*

Applicant Name*

Date*

Parent/Guardian Signature (if applicant is under 18)

Parent/Guardian Name

Date