CMSA SCHOLARSHIP FUND, INC
BLACK HILLS RODEO SCHOLARSHIP FUND, INC.
Scholarship Application for Incoming Freshman Students Academic Year 2018-2019
General Information Applications Must Be Post-Marked By March 1, 2018 for consideration Scholarship recipients will be notified of the decisions The Black Hills Rodeo Scholarship Fund, Inc., was organized to carry on the tradition of rodeo at Black Hills State University with the intent to help and encourage young people to continue with their formal education. The Scholarship is aimed at providing a means to help the student reach their potential and, in that respect, meeting the challenge of making something good happen in today’s world. Eligibility Must be an accepted enrollee or current student at Black Hills State University in good standing. Must have graduated from an accredited high school with a Grade Point Average (GPA) of 2.5 or greater on a 4.0 scale. Home schooled students will be allowed to provide supplemental information to qualify if the information for this requirement is not available. Must fill out application in full and provide supporting documents as required. Copy of Acceptance Letter from BHSU Copy of High School Transcript Essay Be a U.S. citizen or national.
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BLACK HILLS RODEO SCHOLARSHIP FUND AWARD APPLICATION Mail Completed Application to:
Applicant Information 1. Last Name
Black Hills Rodeo Scholarship Fund, Inc. Attn: Travis Lantis PO Box 699 Spearfish, SD 57783-0699
Please print neatly or type. Read the instructions carefully. First Name
MI
2. Social Security Number
3. Permanent Street Address (If PO Box, see instructions) City
State
4. Home Area Code/Telephone Number Zip Code
6. E-mail Address
5. Date of Birth (Month/Day/Year) 7. U.S. Citizen/National
□ Yes 8. High School Attended/School Address
9. Date of Graduation (Month/Year)
10. List high school activities.
11. List high school honors and awards
12. List community service work.
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□ No
13. Please tell us about your best personal achievement.
14. Please explain the field of study you will be pursuing and the degree/certification you are seeking. You must also include a letter of acceptance if a new enrollee at Black Hills State University.
15. Please indicate how you will be paying for your schooling.
16.
On a separate page, please write an essay explaining 1) The impact that rodeo has had upon your life; and 2) Why and how you accept the challenge to make a positive difference in the world.
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17. APPLICANT CONSENT TO RELEASE INFORMATION: I authorize the Black Hills Rodeo Scholarship Fund, Inc., as designated administrator, access to any of my school records for the purpose of verifying the validity of my application information. I authorize a school official at my high school to release the requested information in the School Certification below. Applicant Signature:
Date
School Certification
19a. HIGH SCHOOL CERTIFICATION TO BE COMPLETED BY THE HIGH SCHOOL COUNSELOR, PRINCIPAL, OR OTHER SCHOOL OFFICIAL (See applicant authorization in the APPLICANT STATEMENT OF UNDERSTANDING AND CONSENT TO RELEASE INFORMATION section.) Grade Point Average (GPA) on a 4.0 scale
Class Rank
Class Rank and GPA calculated as of
out of
semester year
ACT Composite : _________________
SAT Score: ________________
School Official Signature
Date
Title School Certification
20a. HOME SCHOOL CERTIFICATION TO BE COMPLETED BY HOME SCHOOL PARENT OR ADMINISTRATOR Grade Point Average (GPA) on a 4.0 scale
Class Rank
out of
ACT Composite: ___________ SAT Score: ____________ You may provide a brief summary of any pertinent information relating to the home school education of this applicant not provided elsewhere in the application. Home School Parent/Administrators Signature
Date
Applicant Statement of Understanding
APPLICANT STATEMENT OF UNDERSTANDING: If I receive the Black Hills Rodeo Scholarship Fund, Inc. scholarship, I understand that my failure to fulfill the educational requirements will convert this scholarship to an interest-bearing loan. I will sign a separate Acceptance and Promissory Note without which my award cannot be finalized and funds will not be disbursed.
Applicant Signature
Date
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Scholarship Application for Incoming Freshman Students Academic Year 2018-2019
General Information Applications Must Be Post-Marked By March 1, 2018 for consideration Scholarship recipients will be notified of the decisions The Black Hills Rodeo Scholarship Fund, Inc., was organized to carry on the tradition of rodeo at Black Hills State University with the intent to help and encourage young people to continue with their formal education. The Scholarship is aimed at providing a means to help the student reach their potential and, in that respect, meeting the challenge of making something good happen in today’s world. Eligibility Must be an accepted enrollee or current student at Black Hills State University in good standing. Must have graduated from an accredited high school with a Grade Point Average (GPA) of 2.5 or greater on a 4.0 scale. Home schooled students will be allowed to provide supplemental information to qualify if the information for this requirement is not available. Must fill out application in full and provide supporting documents as required. Copy of Acceptance Letter from BHSU Copy of High School Transcript Essay Be a U.S. citizen or national.
Page 1 of 4
BLACK HILLS RODEO SCHOLARSHIP FUND AWARD APPLICATION Mail Completed Application to:
Applicant Information 1. Last Name
Black Hills Rodeo Scholarship Fund, Inc. Attn: Travis Lantis PO Box 699 Spearfish, SD 57783-0699
Please print neatly or type. Read the instructions carefully. First Name
MI
2. Social Security Number
3. Permanent Street Address (If PO Box, see instructions) City
State
4. Home Area Code/Telephone Number Zip Code
6. E-mail Address
5. Date of Birth (Month/Day/Year) 7. U.S. Citizen/National
□ Yes 8. High School Attended/School Address
9. Date of Graduation (Month/Year)
10. List high school activities.
11. List high school honors and awards
12. List community service work.
Page 2 of 4
□ No
13. Please tell us about your best personal achievement.
14. Please explain the field of study you will be pursuing and the degree/certification you are seeking. You must also include a letter of acceptance if a new enrollee at Black Hills State University.
15. Please indicate how you will be paying for your schooling.
16.
On a separate page, please write an essay explaining 1) The impact that rodeo has had upon your life; and 2) Why and how you accept the challenge to make a positive difference in the world.
Page 3 of 4
17. APPLICANT CONSENT TO RELEASE INFORMATION: I authorize the Black Hills Rodeo Scholarship Fund, Inc., as designated administrator, access to any of my school records for the purpose of verifying the validity of my application information. I authorize a school official at my high school to release the requested information in the School Certification below. Applicant Signature:
Date
School Certification
19a. HIGH SCHOOL CERTIFICATION TO BE COMPLETED BY THE HIGH SCHOOL COUNSELOR, PRINCIPAL, OR OTHER SCHOOL OFFICIAL (See applicant authorization in the APPLICANT STATEMENT OF UNDERSTANDING AND CONSENT TO RELEASE INFORMATION section.) Grade Point Average (GPA) on a 4.0 scale
Class Rank
Class Rank and GPA calculated as of
out of
semester year
ACT Composite : _________________
SAT Score: ________________
School Official Signature
Date
Title School Certification
20a. HOME SCHOOL CERTIFICATION TO BE COMPLETED BY HOME SCHOOL PARENT OR ADMINISTRATOR Grade Point Average (GPA) on a 4.0 scale
Class Rank
out of
ACT Composite: ___________ SAT Score: ____________ You may provide a brief summary of any pertinent information relating to the home school education of this applicant not provided elsewhere in the application. Home School Parent/Administrators Signature
Date
Applicant Statement of Understanding
APPLICANT STATEMENT OF UNDERSTANDING: If I receive the Black Hills Rodeo Scholarship Fund, Inc. scholarship, I understand that my failure to fulfill the educational requirements will convert this scholarship to an interest-bearing loan. I will sign a separate Acceptance and Promissory Note without which my award cannot be finalized and funds will not be disbursed.
Applicant Signature
Date
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