AMDF inc Scholarship Application

Anna Mae Dancy Foundation, Inc.

Scholarship Application
The Anna Mae Dancy Foundation, Inc is organized and operated exclusively for charitable and educational purposes, including but not limited to mentorship and empowerment of young people in the areas of health and wellness, physical education, academic support and civic involvement under the laws of the Commonwealth of Massachusetts and Section 501(C)(3) of the Internal Revenue Code

Anna Mae Dancy was born in Tupelo, Mississippi on September 28, 1931. She transitioned from this life in Boston, Massachusetts on January 15, 2022. She was married to the late James Dancy where their marriage gave life to and blessed 7 children and a host of grandchildren. She was the epitome of an Educator and a Coach. She was truly about academic excellence. She taught History, Health and Physical Education to thousands of young people in Mississippi, Missouri and Massachusetts.

She was a Godly woman who fervently believed that higher learning was the road to unlimited opportunities. As the youngest of 12 siblings & the only college graduate; she knew that to whom much is given much is required. Despite all her accomplishments, she never lost focus of that guiding principle. In her memory we make this scholarship available to assist deserving high school seniors in financial need.

In addition, we thank the City of Boston for declaring September 28th as “Anna Mae Dancy Day
Qualifications Scholarship:
• High School Senior with a GPA of 3.0+
• Submit two letters of recommendation from a High School Counselor, Educational or Community Organization Leader
• Submit a letter of acceptance on official letterhead from an accredited college or university.(a clear copy of the letter is acceptable)
• Submit Official High school transcript
• Submit a 500-1,000 word Essay on a need(s) in your community and how you plan to give back to meet the needs(s) while in college and beyond to make a difference.
ATTENTION:

This form may be saved and submitted later. Failure to enter all fields will prevent application submission.

Completed applications are due by Tuesday, May 20th, 2025 at 5:00pm.

STUDENT INFORMATION
Name*

First NameMiddle InitialLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*

Area CodePhone Number (000-0000)

PARENT/LEGAL GUARDIAN INFORMATION

If inapplicable please fill the text box with "N/A"
Mother's Name (or Guardian) :*

First NameLast NameSuffix
Mother's/Guardian Email Address
example@example.com
Home Telephone Number

Area CodePhone Number
Mobile/Alternate Number*

Area CodePhone Number
Father's Name (or Guardian)*

First NameLast NameSuffix
Father/Guardian Email Address*
example@example.com
Home Telephone Number

Area CodePhone Number
Mobile/Alternate Number*

Area CodePhone Number
Number of Household Members*
Example: For a family of five, select the drop down 5.

SCHOOL INFORMATION
Current High School*
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guidance Counselor's Name*

PrefixFirst NameLast NameSuffix
Guidance Counselor's Phone Number*

Area CodePhone Number
Guidance Counselor's Email*
example@example.com
Current Grade Point Average*
Example: 3.0/4.0 scale
Weighted GPA (if applicable)

List of Extracurricular Activities*
Example: Chess Club, Community Service Council, etc.
Community Service/Involvement*
Example: Harvester's Food Packager, MLK Program Volunteer
Scholarships, Honors and Awards Received (if inapplicable please type "None at this time.")*
College expected to attended*
Prospective Major or Undecided*
Prospective Minor (if applicable)

Required Documents
High School Transcript*

Browse Files
Must be the most current transcript from the previous semester Cancelof
College Acceptance Letter

Browse Files

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Recommendation Letter #1*

Browse Files

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Recommendation Letter #2*

Browse Files

Cancelof

Essay Question
What are your educational and professional goals and objectives?*

0/100
Please submit a 500-1,000 word essay to the proposed question. The submission should be in the format of pds, doc, txt or png.

What is a need(s) in your community and how do you plan to give back to meet the need(s) while in college/workplace and beyond to make a difference?
Upload Essay Here*

Upload File
pdf, doc, docx, txt, or png Cancelof

If you receive the scholarship, are you willing to speak and/or write an excerpt for our website and/or social media? The excerpt would pertain to how we have helped you in your plight of success.
YesNo
I agree that all information completed on this application and documents submitted are true to the best of my knowledge. I understand that application and submissions will be used for purposes of determination of admission to the Giving Hope & Help Education Is Your Passport Scholarship Program. I also understand that completion of application does not guarantee admission or benefits of the program.
Date*

MonthDayYear
DateHourMinutesAM/PM Option
Signature of Applicant*

Clear
Date*

MonthDayYear
DateHourMinutesAM/PM Option
Signature of Parent/Guardian*

Clear
Should be Empty:

Anna Mae Dancy Foundation, Inc.

STUDENT INFORMATION

PARENT/LEGAL GUARDIAN INFORMATION

SCHOOL INFORMATION

Required Documents

Essay Question