Gweedo Memorial Scholarship

Gweedo Memorial Scholarship Application Form

Application Deadline - May 1st
If selected, you may be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below.

Thank you for taking the time to apply. Awardees will be personally notified when determinations are made.

Please ensure your application is complete. Unfortunately, incomplete applications cannot be considered
I. Personal Data

Tell us about yourself
Full Name*

First NameLast Name
Birthdate*

MonthDayYear
Mobile No*
Email *
Where the confirmation will be send to
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender

MaleFemale
Are you a US citizen?*

YesNo
Guardian Information

First NameLast Name
Guardian Email
example@example.com
Guardian Phone
Please enter a valid phone number.
II. Academic Information
Are you or will you be a high school graduate this year?*

YesNo
Current or Most Recent School Attended*
Cumulative Overall Grade Point Average, (unweighted GPA)**
Minimum 3.0 unweighted GPA required for eligibilty
What College/University/Vocational/Technical School do you plan to attend in the Fall?*
At the time of this Application have you been accepted/offered admission to the above school?*

YesNo
Anticipated Major/Course/Trade of Study
How many Credit Hours do you plan to take per semester?
When do you Anticipate Graduating from/Completing your field of Study*

MonthDayYear
Date

Please provide your estimated expenses (per YEAR)

	Estimated ANNUAL Costs
Tuition
Room and Board
TOTAL

What Degree or Certification do you expect to attain(B.S., B.A., etc)*
III. Financial Information

Financial Aid Sources

Please indicate available financial aid resources. If Unknown(UNK) or Not Applicable(N/A) please indicate that for each line item:

	Description	Dollar Amount	Frequency
Grants
Scholarships
Loans
Trust Funds Available
Tuition Reimbursement
Student's Contribution
Other Sources of Aid

IV. Hobbies/Activities/Volunteer Experience

Note: Do not list the same activity in more than one area. Should you prefer to upload a file with this information instead of filling out the fields, please do so at the end of this application:

Community/Church Activities (within past 5 years)

	Activity/Organization	Dates of Involvement	Description of your Participation	Volunteer Hours Earned
1
2
3
4
5

High School Activities (activities, athletics, clubs, organizations) including any leadership positions:

	Activity/Organization	Dates of Involvement	Description of your Participation	Volunteer Hours Earned (if applicable)
1
2
3
4
5
6
7
8

Please tell us about any academic recognitions/honors or special awards you have received:*
Personal hobbies, activities, and/or interests outside of school:*
Do you have any special talent or skills you would like to develop?
V. Employment History

Please provide employment history, most recent first:

	Employer Name	Dates Employed	Supervisor's Name	Phone Number	Full-time or Part-time?
1
2
3
4

VI. Application Requirement:
REQUIRED

Create two Distracted Driving posts for use on a social media campaign, using Facebook, Instagram or Twitter, promoting safe driving and creating better driving habits in young drivers.
- Keep an emphasis on reckless driving, speeding, driving without a license, and how to speak up when you are a passenger in a vehicle being driven unsafely.
- Think about how social media influences us and how this post could be used to help deter the factors that led to Conner’s unnecessary death.
- Submission must include a minimum of (2) different posts that incorporate graphics, live actors, reenactments, and/caricatures or clips.
- Include yourself and The Gweedo Memorial Foundation in your tag.
Posts must be submitted for approval prior to posting.

Screenshots/clips/mock-ups of your posts can be attached at the end of this form or emailed directly to tammygweedomcgee@gmail.com

Submissions will be judged on the following criteria:
- Originality and creativity (Is it unique and creative?)
- PSA concept (Is the message and concept effective?)
- Clarity of message (Is the idea communicated clearly?
Your post can not contain nudity, violence, self-injury or profanity. Your post can not include content intended to shock or disgust viewers, or content encouraging others to commit violent acts.
Please provide us with any additional information you would like to share:

0/500
Please upload your transcript, at least two Letters of Recommendation, and all other supporting documents here. *

Cancelof
VIII. Applicant's Authorization
By submitting this applicaton, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Should be Empty:

Gweedo Memorial Scholarship Application Form

I. Personal Data

II. Academic Information

III. Financial Information

IV. Hobbies/Activities/Volunteer Experience

V. Employment History

VI. Application Requirement:

VIII. Applicant's Authorization