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Scholarship Application

2018 Stampede Foundation Scholarship Application

The application deadline is February 16, 2018. All applicants will be notified in writing of the status of their application by April 15th, 2018. The Stampede Foundation will present the scholarship award certificates at a date and location still to be determined. Event details will be sent in April letter.
Parents: Please take a moment to consider your involvement with your child's application. It is the student's responsibility to complete the scholarship application. Parents/guardians may assist or guide, but they should allow students to be responsible adults and achieve success on their own merits.
APPLICANT CONTACT INFORMATION:
First Name
Middle Initial
Last Name
Permanent Address
(please provide your full mailing address)
City
State
Zip Code
Phone Number
Numbers ONLY, no dashes, periods etc. 1234567890
Name of High School last attended
Date of Birth

_________________________

EDUCATIONAL INSTITUTION you plan to attend in the fall of 2017 (list your 1st and 2nd choices):
1st Choice
2nd Choice
What is your field of study?
What is your intended field?
HOUSEHOLD/FINANCIAL INFORMATION:
FAFSA Student Aide Report or Federal Tax Form 1040
If you would like to be considered for need based scholarships and you've applied for federal financial aid, attach all pages of your 2017/2018 Student Aid Report (SAR). For more information, see www.fafsa.ed.gov. If you did not apply for federal financial aid but would like to be considered, attach the first two pages of your parent's or guardian's most recent Federal Tax Form 1040 (or your own if you are not a dependent).
FAFSA Student Aid Report or 1040 Tax Form
 
All documents must be received on or before February 16, 2018. Anything received after this time will not be considered. If you are having trouble submitting your financial information, you can email it to hinderaker@comcast.net or fax it to 970-356-3103. If you have any questions please contact Bob Hinderaker at 970-371-0863.
Total Number of people living in the Household including those who are not dependents

_________________________

EMPLOYMENT:
Beginning with your present or most recent job, list your last three paid work or business experiences.
Are you currently employed?

1. Employer name and address
Supervisor name and phone number
Dates of employment
2. Employer name and address
Supervisor name and phone number
Numbers ONLY, no dashes, periods etc. 1234567890
Dates of employment
3. Employer name and address
Supervisor name and phone number
Dates of employment
HIGH SCHOOL INVOLVEMENT (Awards and Honors)
 
Choose the three most important awards/honors you have received during high school.  Briefly explain what the awards/honors are and what they are given for, elaborate on why your received them, and identify their significance. 
Award/Honor #1
Award/Honor #1 Received From (list organization)
Date Received
What is it? Why did you receive it? Significance? Additional information:
Award/Honor #2
Award/Honor #2 Received From (list organization)
Date Received
What is it? Why did you receive it? Significance? Additional information:
Award/Honor #3
Award/Honor #3 Received From (list organization)
Date Recieved
What is it? Why did you receive it? Significance? Additional information:

_________________________

ACTIVITIES:
Choose the three most significant school-related activities (including athletics, music, clubs or theater) in which you have participated during high school. Elaborate on what they are specifically and how they have played a role in your intellectual and personal development.
Activity #1
Honors, positions held, letters earned
Dates of involvement
Hours per month
What is it? How has it played a role in your intellectual and personal development?
Additional Space for Activity #1
Use this additional space if necessary
Activity #2
Honors, positions held, letters earned
Dates of involvement
Hours per month
Honors, position held, letters earned
What is it? How has it played a role in your intellectual and personal development?
Additional Space for Activity #2
Activity #3
Honors, positions held, letters earned
Dates of involvement
Hours per month
What is it? How has it played a role in your intellectual and personal development?
Additional Space for Activity #3

___________________

COMMUNITY INVOLVEMENT:
Choose three significant community activities in which you are or have been involved. Elaborate on what the community activities are specifically, the role they played in your personal development, and the role you played in contributing to the success of the activity. Please provide a name and phone number of someone we can contact to verify your involvement.
Activity Description #1 (please include position held)
Organization contact name
Organization contact phone number
Numbers ONLY, no dashes, periods etc. 1234567890
Dates of involvement
Hours per month
What is it? How did it contribute to your personal growth? How did you contribute to the activity?
Activity Description #1 Additional Space
Activity Description #2
Organization contact name
Organization contact phone number
Numbers ONLY, no dashes, periods etc. 1234567890
Dates of involvement
Hours per month
What is it? How did this contribute to your personal growth? How did you contribute to the activity?
Additional Space for Activity Description #2
Activity Description #3
Organization contact name
Organization contact phone number
Numbers ONLY, no dashes, periods etc. 1234567890
Dates of involvement
Hours per month
What is it? How did this contribute to your personal growth? How did you contribute to the activity?
Additional Space for Activity Description #3

___________________

PERSONAL STATEMENT:
 
Please attach a personal statement (no more than two pages double-spaced). In the statement, you should include: 
 
  • A brief history about your background including information about your family influences.
  • Your life goals and what you hope to achieve.
  • Describe how  you have been a positive role model in your school or community and your plans to incorporate service and volunteerism into  your immediate future.
  • Who or what has been the biggest influence in your decision to pursue additional education in your chosen field? Why?
  • Describe any special circumstances that may affect your family's ability to pay for college (medical, divorce, unemployment, child support, other).
Personal Statement attachment
 

___________________

TRANSCRIPTS:
Official Transcript Request - FOR HIGH SCHOOL SENIORS ONLY
Please attach your official transcript. The transcript should include your class rank and ACT Scores.
Transcripts/Certificate - FOR CONTINUING & NON-TRADITIONAL APPLICANTS
Please scan and attach the official transcript or GED Certificate of Completion. You will not be able to submit your application until you have attached your official transcript.
All transcripts/certificates must be received on or before February 16, 2018. Documents received after this time will not be considered. If you are having trouble submitting the transcript, you can email it to scholarships@greeleystampede.org or fax it to 970-356-3103.
Transcript attachment
 

___________________

LETTERS OF RECOMMENDATION:
In this section, we ask that you attach two letter of recommendation on your behalf.
One letter of recommendation MUST be from a TEACHER, COACH, OR ACADEMIC (NON-FAMILY MEMBER).
The second letter MUST be from a WORK OR VOLUNTEER SUPERVISOR, A YOUTH LEADER OR PERSONAL ACQUAINTANCE (NOT FROM A TEACHER/COUNSELOR OR FAMILY MEMBER).
The letters MUST include:
  • Recommender's Full name
  • Recommender's Title
  • Recommender's organization
Your application will not be complete until the both letters of recommendation have been submitted.
First Letter of Recommendation
 
Second Letter of Recommendation
 

___________________

PHOTOGRAPH:
Please upload a current photo of yourself. Photos should be high quality, headshot images. The uploaded image may be used to on the Greeley Stampede scholarship website page and social media as well as on Greeley Stampede Foundation printed materials and presentations.

By uploading an image, you hereby authorize the use, reproduction, and publishing of photographs without compensation. You understand that this material may be used in various publications and/or websites, for any lawful purpose including publicity advertising or journalism. This material may also be cropped, edited, or retouched without my further approval. The authorization is continuous and may only be withdrawn by your specific
rescission of this authorization.
Headshot Photo
 
First Name
Last Name
Email Address
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