HR100 Form

HONOR ROLL 100 APPLICATION

CHARLEY P. & ORSOLINA TOPPINO MEMORIAL SCHOLARSHIP
Eligibility Requirements: The Honor Roll 100/Charley P. & Orsolina Toppino Memorial Scholarship Award is available annually to a student who is graduating from a high school located in Key West or a graduating student who resides in Key West. The scholarship committee looks at financial need, personal need, and academic achievement. Your family contribution must be equal to or less than $22,780 to be eligible for this scholarship.

Personal Information
Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Are you a resident of Monroe County? *

Yes No

Parental Information
Name of Parent or Guardian

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Academic Information
Name of High School Attended
High School Transcript Upload *

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What is your high school grade point average (4.0) weighted only *
Community Service Hours *
SAT Score: Math Number* Verbal Number*
Date Taken: Date*
ACT Composite Score Number* Date Taken Date*

List in order of importance all extracurricular activities, school or community, in which you have participated during your high school career: (Do not include employment.)

	Activity	Date of Participation	Offices Held
1
2
3
4

List all honors or awards you have received during high school:
Please list any dual enrollment and advanced placement courses you have taken or are currently enrolled:

List the colleges to which you have applied:

	Institution	City/State	Accepted (yes/No)
1
2
3
4

What is your expected major? *

Financial Data
Please attach the FAFSA summary sheet and an explanation describing the basis of your financial need and any extenuating circumstances (e.g. single parent family). If the source of funds for coming year is not equal to or greater than your anticipated expenses, also attach an explanation indicating how you plan to make up the difference. The scholarship sub-committee reviews all applications as a collective group. A major component of this scholarship is the student’s ability to express a sincere financial need within the application for review. To answer the following questions, you may want to discuss your current financial situation with those involved in financing your current college/university track, if any.
FASFA Forms *

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Please explain any family circumstances that may have a financial effect on your plans for college, such as siblings or other family members in college, private tuition, etc.

Anticipated Expenses for the Coming Year

	Expenses
Tuition
Transportation
Room & Board
Books & Supplies
Clothing
Personal Misc.
Other
Total

Source of Funds for the Coming Year

	Funds
Parents
Scholarships*
Employment
Applicant Savings
Other
Total

* Please list only the scholarship funds you have already received
Are you currently employed? *

Yes No

If so, where, in what capacity, and how many hours per week?

	Company	Position	# of Hours
1
2
3
4

Do you plan to be employed while attending college? *

Yes No Unsure at this time

References
Letter of Recommendation from current Teacher or Administrator

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Letter must be on school letterhead. If you do not have a letter to upload. Please have letter sent to: Key West Chamber of Commerce Foundation, 510 Greene Street, Fist Floor, Key West, FL 33040. Letter must be received no later than March 31, 2023 Cancel of
List the names, addresses and telephone numbers of three individuals (not relatives) who may serve as references. These people should know you and your academic record well. One must be a teacher or administrator from your high school and a letter of recommendation is required from this person. The other two do not need to provide a letter.

References *

	Name	Address	Phone Number
1
2
3

Supporting Material
Upload Your Essay Here (As indicated below) *

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On a separate sheet of paper, please state your contribution to the community, your school, civic and religious activities, as well as something about yourself and why you wish to be considered for this scholarship. Include your plans and goals for the future; and how you hope to achieve them. This is your chance for our committee to get to know you. (Maximum length of two pages typed and double-spaced.)
Please sign and date this application and agree to attach a certified copy of your high school transcript.

Please note that incomplete applications cannot be accepted.
Applicant's Signature

Clear
Name of Applicant

First Name Last Name
Date Signed by Applicant

Month Day Year
Date
If selected, the first installment of the scholarship grant check will be payable when the student forwards a copy of the signed registration document containing the raised seal with proof of registration from the selected college or university to the Greater Key West Chamber of Commerce. The Chamber of Commerce will provide a letter stating monies will be forthcoming.
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HONOR ROLL 100 APPLICATION

Personal Information

Parental Information

Academic Information

Financial Data

References

Supporting Material