William C. Ptacek Scholarship Foundation Application Form

William C. Ptacek Scholarship Foundation

Scholarship Application Form
The William C. Ptacek Scholarship Foundation was created in memory of William (“Bill”) Ptacek, and this scholarship celebrates his lifelong love of music. The foundation awards $1,000 scholarships to graduating seniors of Oakes High School who plan to continue their education after graduation and who have demonstrated dedication and excellence in music as well as academics.

Scholarship Program Application Requirements
- Complete the form below.
- Attach a copy of your most recent academic transcript (high school, college, university, or trade school).
- Attach a copy of your college entrance examination scores (ACT and/or SAT).
- Attach a list outlining your high school honors (other than music), community and school activities, and your employment history.
- Attach one or more letters of reference from a teacher, counselor, employer, pastor or mentor.
- Attach a short essay written by you entitled, "Why Music is Important to me" (Maximum of 500 words).
Applications must be received by 11:59pm Central Time on April 15, 2026.
Incomplete or late applications will not be considered.

The number of awards may vary. A minimum of one scholarship will be awarded in the amount of $1000.

All scholarship entries are confidential and will only be viewed by the William C. Ptacek Scholarship Foundation Selection Committee. However, if your scholarship application is selected for award, your name, your parents’ names, information about your high school achievements, and the name of the institution of higher education you plan to attend may be used for publicity purposes. Recipients may also be asked to provide additional information (e.g., social security number).

Scholarship Fund Registered Agent:
Cassie Ptacek Johnson
wcpscholarship@gmail.com

Applicant Overview
Applicant Name*

First NameLast Name
Applicant Email Address*
example@example.com
Primary Phone Number for Applicant*
Please enter a valid phone number.Format: (000) 000-0000.
Permanent Address for Applicant*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent(s) / Guardian(s) Name(s)*
Name of Accredited Institution of Higher Education the Applicant Plans to Attend*
Location of Accredited Institution of Higher Education the Applicant Plans to Attend*
Intended Major Field(s) of Study*
Intended Minor Field(s) of Study*
Post-Education Career Plans*
YesNo

Summary of Music-related Honors and Achievements
Solo and Ensemble Participation
Grade 10:*
Grade 11:*
Grade 12:*
District/Regional and/or All-State Band/Choir/Orchestra Participation
Grade 10:*
Grade 11:*
Grade 12:*
Other Music Honors and/or Awards Received
Grade 10:*
Grade 11:*
Grade 12:*
Private Study
Describe any private lessons or other private study of voice or other instrument(s). If none, type "not applicable."*

Supporting Documentation
In this section, attach the following documents:
- A copy of your most recent academic transcript (high school, college, university, or trade school).
- A copy of your college entrance examination scores (ACT and/or SAT).
- A list outlining your high school honors (other than music), community and school activities, and your employment history.
- One or more letters of reference from a teacher, counselor, employer, pastor or mentor.
- A short essay written by you entitled, "Why Music is Important to Me" (Maximum of 500 words).
Academic Transcript*

Attach a copy of your most recent academic transcript.
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College Entrance Exam Scores*

Attach a copy of your college entrance exam scores.
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List of Non-music Activities, Achievements and Employment*

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Letter(s) of Reference*

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500-word Essay: What Music Means to Me*

Cancelof

Attestations
I certify that the information provided in this scholarship application is true and complete to the best of my knowledge.If selected as a recipient, I grant permission for my name, parents’ names, information about high school achievements, and the name of the institution of higher education I plan to attend to be used in announcements or publicity related to the scholarship.
Student's Full Name*
By typing my name and submitting this form, I acknowledge that my typed name serves as my electronic signature.
Date*

MonthDayYear
Date
I confirm I am the parent or legal guardian of the applicant.I certify that the information provided in this scholarship application is accurate to the best of my knowledge.If applicant is selected as a recipient, I grant permission for their name, parents’ names, information about high school achievements, and the name of the institution of higher education the applicant plans to attend to be used in announcements or publicity related to the scholarship.
Parent / Guardian's Full Name
By typing my name and submitting this form, I acknowledge that my typed name serves as my electronic signature.
Date

MonthDayYear
Date
Should be Empty:

William C. Ptacek Scholarship Foundation

Scholarship Program Application Requirements

Applicant Overview

Summary of Music-related Honors and Achievements

Solo and Ensemble Participation

District/Regional and/or All-State Band/Choir/Orchestra Participation

Other Music Honors and/or Awards Received

Private Study

Supporting Documentation

Attestations