High School Scholarship Application Form

Madison Wegener Memorial Scholarship Application

The information provided on this form will be used by the Madison Wegener Memorial Scholarship Committee to select up to three recipients for three individual $1,000 scholarships. While this scholarship is not based upon academic achievements or financial need, committee members still wish to get a feel for you as a high school student. It is therefore important that you give complete details concerning your college/career plans, achievements, and activities. Completed applications must be submitted by May 19, 2023.
The Madison Wegener Memorial Scholarship was established in 2020 to honor the memory of Madison Wegener, a freshman at BHS who died at the age of fourteen. As 2023 would have been her senior year of high school, it is only appropriate that the first scholarships be awarded to members of her graduating class.

At the age of six, Madison was diagnosed with idiopathic pulmonary hypertension, a rare, degenerative disease that is currently without a cure. Living with a rare disease means managing unique challenges, including freqient doctor visits, rigorous treatment routines, and hospitalizations. Yet, she continually faced her disease with humor, grace, and courage. She never took a "Why me?" approach to life and instead wished to become a doctor, helping kids just like her.

The scholarship is open to Brighton High School seniors planning to attend an accredited two or four-year college, technical school, or university beginning in the upcoming fall. Scholarship recipients will be selected based upon their response to an essay question in which the student demonstrates how their career path was inspired by adversity or a challenge that they were forced to overcome and the degree to which that career will contribute or help others facing similar challenges.
BASIC INFORMATION
Student's Full / Legal Name*

First NameLast Name
Student ID:*
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Phone Number*

Area CodePhone Number
Student E-mail*
Student Birth Date

MonthDayYear
Gender
Academics
Academic GPA*
Class Rank
Schools to Which You Are Applying/Accepted
School 1
School 2
Will Live
Major(s) You Are Considering

In order of preference, list the major(s) you are considering. (This is very important for scholarship eligibility.)
Major 1
Major 2
Minor
REFERENCES:

Please list one educator and at least one community person (non-relative) who would recommend you for a scholarship. Please do not list the person who completes a scholarship recommendation for you.
Reference 1 Name (Position, Phone Number)
Reference 2 Name (Position, Phone Number)
SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

List name of club, etc. and years of participation. If you volunteered, list the name of organization and the number of hours, weeks and years that you volunteered. If you worked, list the company, hours per week and length of time. Attach an additional sheet or resume if necessary.
School Activities / Offices Held 1: (not sports)
School Activities / Offices Held 2: (not sports)
School Activities / Offices Held 3: (not sports)
Community Service / Volunteer Activities 1 (outside of school)
Community Service / Volunteer Activities 2 (outside of school)
Community Service / Volunteer Activities 3 (outside of school)
Sports Participation 1
Sports Participation 2
Sports Participation 3
Travel Experience or Unusual Experiences (mission trips, etc.)
EMPLOYMENT 1: List past and present work and length of time employed.
EMPLOYMENT 2: List past and present work and length of time employed.
EMPLOYMENT 3: List past and present work and length of time employed.
SCHOLARSHIP RECEIVED TO DATE 1
AMOUNT 1
SCHOLARSHIP RECEIVED TO DATE 2
AMOUNT 2
Madison faced a number of challenges in her young life, including navigating a life-threatening illness, physical limitations, social stigma for seemingly being different, and more. Yet, her response to these challenges was admirable. When she caught someone staring, she met their eyes with a smile. When she had to give up an activity that she loved, she explored others that were within her limitations. When she was stuck in the hospital for days and weeks at a time, she found ways to make others laugh. She refused to grow up too fast, despite the fact that she was often wise beyond her years, and she recognized the importance of living life to the fullest. Instead of asking "Why me?" she worked to raise awareness and research funds. Despite the fact that the odds were stacked against her, she set her mind to becoming a PH doctor so that she could help others like herself. In essence, she taught a lot of life lessons.

Within your essay, please describe a specific challenge or adversity that you have faced. To what degree did it affect your life, and how did you address it? What impact has it had on shaping you into the person that you are today? Finally, how has this challenge or adversity inspired your career path, and how will that career path help others who face similar adversities/challenges?
Essay Response * Please respond to the above prompt in 750 words or less. *

0/750
Letter of Recommendation

Please upload a letter of recommendation written on your behalf by a non-relative.
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Madison Wegener Memorial Scholarship Application

BASIC INFORMATION

Academics

Schools to Which You Are Applying/Accepted

Major(s) You Are Considering

REFERENCES:

SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

Letter of Recommendation