$1,000 Scholarship
The 2018 Douglas Picott Memorial Scholarship
$1,000 will be awarded to a selected student who attended Southeastern Elementary School
REQUIREMENTS:
· Must be a Chesapeake Public School graduating senior
· Must have attended Southeastern Elementary School
· Must have a GPA of 3.0 or higher
· Must complete application and essay by April 20, 2018
· Must be accepted to a college or university.
Application location: High school guidance office
Application deadline: April 20, 2018
Recipient notification: May 4, 2018
Additional information: Contact seepta1@gmail.com
Application for 2017 Doug Picott Memorial Scholarship
Sponsored by Southeastern Elementary School PTA
Page 1
Requirements:
· Must be a Chesapeake Public School graduating senior
· Must have attended Southeastern Elementary School
· Must have a GPA of 3.0 or higher
· Completed application and essay turned in by the deadline
· Acceptance to a college or university.
Personal Information:
Name: ___________________________________________________________________
Student ID number: _________________________________________________________
Date of birth: ______________________________________________________________
Street address: _____________________________________________________________
City, State, and Zip: _________________________________________________________
Mobile phone: ____________________________Other phone:_______________________
Email address: _____________________________________________________________
Education Information:
Years attended Southeastern Elementary school: __________________ years
High school anticipated graduation date: _______________________________________
GPA: __________________________
College/ University attending: ________________________________________________
Course of study/major: ______________________________________________________
Work Experience, Awards, Volunteer, and Extracurricular Activities
(Please list and describe below. Feel free to type it and attach on a separate sheet of paper).
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Application for 2018 Doug Picott Memorial Scholarship
Sponsored by Southeastern Elementary School PTA
Page 2
Supporting Documentation
The following must accompany the application:
_______1. Essay of 500 words or less on the following topic:
Reflecting back on your days as a student at Southeastern Elementary School, what experiences prepared you for your upcoming role as an undergraduate student?
_______ 2. Two (2) Letters of Recommendation from teachers at your current school
_______ 3. A copy of your current Official High School Transcript (GPA of 3.0 or higher)
Department Chair/ Principal: _________________________________________ (print)
_________________________________________ (sign)
Counselor/ Advisor: _________________________________________ (print)
_________________________________________ (sign)
Certification Statement
I certify that all of the information contained in this application is true and complete to the best of my knowledge.
Signature of Applicant: ______________________________________ Date: ___________
Signature of Parent/ Guardian: ________________________________ Date: ___________
Please return completed application, essay, and documentation to the main office at Southeastern Elementary School, ATTN: SEE PTA. Please provide the originals and one copy of each.
Application Deadline: April 20, 2018
Award Notification: May 4, 2018
