Please print and fill out

 

TEXAS ASSOCIATION

FAMILY, CAREER AND COMMUNITY LEADERS OF AMERICA

SCHOLARSHIP APPLICATION

 

RETURN BY MARCH 1, 2008.  Please complete and return to Family, Career and Community Leaders of America, 3530 Bee Caves Road, Suite 101, Austin, Texas, 78746.

 

Send with Application:

 

1         Copy of transcript of high school grades

3         Letters of recommendation

1          Typewritten copy of appropriate theme(s)

 

Name of Applicant:                                                                                                                  

                                    (last)                             (first)                            (middle)

 

Social Security Number:                                    -                       -                                 

 

Date of Birth:                                          Place of Birth:                                                

 

Region:  I     II    III     IV    V   FCCLA Chapter:                                                                    

 

Name of High School and School District:                                                                                

 

School Address:                                                                                                                      

 

City:                                                        Zip Code:                    Phone #:  (      )                      

 

Father’s Occupation:                                          Mother’s Occupation:                                    

 

Number of children in your family and their ages:                                                                      

                                                                        (Number)                                 (Ages)

Name of local FCCLA Advisor:                                                                                              

 

Advisor Address:                                                                                                                     

 

City:                                                        Zip Code:                    Phone #:  (      )                      

 

 Number of years:

_________  # of years of Family and Consumer Sciences Instruction completed

_________  # of years of Active Membership in FCCLA

 

Name of college or university is the applicant is planning to Attend:                                ­­­­­­­

 

What is your major (any area of family and consumer sciences?)
                                                                                                                                               

 

Test score of American College Test (ACT)                               Scholarship Aptitude Test              (SAT)                               

 

I.  List activities, duties, responsibilities and participation in Family, Career and                                    Community Leaders of America: 

II.                 List:

 

(a1)     Supervised Career Connection Activity:  (This activity is required of students enrolled in Comprehensive and Technical family and consumer sciences) OR  (a2) Occupational training experiences (for students enrolled in occupational specific classes)

(b)            Other Family Responsibilities:

III.  School Organizations Or Activities:

 

 

 

 

 

 

 

 

List other School Activities:

 

 

 

 

 

 

 

IV.  Community, Church, other Organizations or Activities:

 

 

 

 

 

 

 

 

V.               Describe your need for financial assistance.  The extent that this scholarship would help to make college possible for you should be included.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VI. Educational and Career Goals:                                                                                                                                                          

 

 

 

 

 

APPLICANT’S SCHOLARSHIP RECORD

 

 

I hereby certify that                                                                                                        has an overall grade average of 85 in                                                                          High School.

Signed:                                                                                                            

(Principal)                                            

 

 

 

STATEMENT OF APPLICANT, PARENT,

FCCLA SPONSOR, AND CHAPTER PRESIDENT

 

We examined this application and find the record true, complete and accurate.