Renewal Application
(Renewal Application) While in high school, you were awarded the FRANK AND LILLIAN POUCHER SCHOLARSHIP. The purpose of this scholarship is to aid/assist indigent students of Atlantic City High School, who reside in Atlantic City, to continue their education past high school (Ex: 2 year college, 4 year college, Vocational School, Business School). The criterion that was used to initially identify eligible candidates was: (1) Students suffering sickness, unusual circumstances or other misfortunes. (2) Students eligible for free or reduced lunch. Recipients of this scholarship are able to reapply each year for renewal of their scholarship until they have completed their education. Note: Renewals are not automatic and the amounts may change year to year.
Renewal Applicants: In order to renew the scholarship, recipients must provide: (1) current proof of Atlantic City residency (Student or Parent Drivers’ License, utility bill, income taxes or payroll stub) (2) a current transcript showing satisfactory grades (3) a copy of their fall semester grades (4) two (2) letters of recommendation (at least one from a college representative) (5) verification of your income and your parents’ income (tax return, payroll stub).
Please return completed application to Atlantic City High School Guidance Department on or before April 13, 2018. 1400 N. Albany Avenue Atlantic City, NJ 08401 [email protected]
FRANK AND LILLIAN POUCHER SCHOLARSHIP Renewal Application 2017-2018
Name ________________________________________________________________________ Last
First
Middle
Address ______________________________________________________________________ Street
______________________________________________________________________________ City
State
Zip Code
Telephone #____________________________________________________________________ Home
Cell
Email address __________________________________________________________________ D.O.B. _____________ Age _______ Sex ______ Social Security # __XXX-XX-___________ Year of Graduation from ACHS___________
Expected date to receive BS/BA_____________
BACKGROUND INFORMATION Mother’s Name ________________________________________________________________ Address ______________________________________________________________________ Name & Address of Employer _____________________________________________________ Position ________________________ How Long? __________ Yearly Income _____________ Father’s Name _________________________________________________________________ Address ______________________________________________________________________ Name & Address of Employer ____________________________________________________ Position _______________________ How Long? __________ Yearly Income _____________ Number of Siblings __________ Sisters ________ Brothers _______ Total in college ______
Applicant’s Employment Record Employer 1. 2. 3.
Position
Date
Salary
To what school will you be attending in the upcoming year?
Approximate Tuition
______________________________________________________
__________________
What course of study/profession/vocation do you plan to pursue? ______________________________________________________________________________
What degree do you currently hold? ________________________________________________ What degree are you seeking?_____________________________________________________
List extra-curricular and community activities have you been involved after high school? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
List all honors and awards you have received (after high school) in your school and community. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
ESSAY In typed, essay format, tell something about your experiences after high school that will assist the Selection Committee to decide whether to renew your Frank & Lillian Poucher Scholarship. (300-500 words)
___________________________________________________ Applicant’s Signature
____________________ Date
___________________________________________________ Parent’s Signature
____________________ Date
Renewal Applicants: In order to renew the scholarship, recipients must provide: (1) current proof of Atlantic City residency (Student or Parent Drivers’ License, utility bill, income taxes or payroll stub) (2) a current transcript showing satisfactory grades (3) a copy of their fall semester grades (4) two (2) letters of recommendation (at least one from a college representative) (5) verification of your income and your parents’ income (tax return, payroll stub).
Please return completed application to Atlantic City High School Guidance Department on or before April 13, 2018. 1400 N. Albany Avenue Atlantic City, NJ 08401 [email protected]
FRANK AND LILLIAN POUCHER SCHOLARSHIP Renewal Application 2017-2018
Name ________________________________________________________________________ Last
First
Middle
Address ______________________________________________________________________ Street
______________________________________________________________________________ City
State
Zip Code
Telephone #____________________________________________________________________ Home
Cell
Email address __________________________________________________________________ D.O.B. _____________ Age _______ Sex ______ Social Security # __XXX-XX-___________ Year of Graduation from ACHS___________
Expected date to receive BS/BA_____________
BACKGROUND INFORMATION Mother’s Name ________________________________________________________________ Address ______________________________________________________________________ Name & Address of Employer _____________________________________________________ Position ________________________ How Long? __________ Yearly Income _____________ Father’s Name _________________________________________________________________ Address ______________________________________________________________________ Name & Address of Employer ____________________________________________________ Position _______________________ How Long? __________ Yearly Income _____________ Number of Siblings __________ Sisters ________ Brothers _______ Total in college ______
Applicant’s Employment Record Employer 1. 2. 3.
Position
Date
Salary
To what school will you be attending in the upcoming year?
Approximate Tuition
______________________________________________________
__________________
What course of study/profession/vocation do you plan to pursue? ______________________________________________________________________________
What degree do you currently hold? ________________________________________________ What degree are you seeking?_____________________________________________________
List extra-curricular and community activities have you been involved after high school? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
List all honors and awards you have received (after high school) in your school and community. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
ESSAY In typed, essay format, tell something about your experiences after high school that will assist the Selection Committee to decide whether to renew your Frank & Lillian Poucher Scholarship. (300-500 words)
___________________________________________________ Applicant’s Signature
____________________ Date
___________________________________________________ Parent’s Signature
____________________ Date
