Fillable 2293JessenFamily FORM Kay and Jerry Jessen Scholarship Application

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2293JessenFamily FORM Kay and Jerry Jessen Scholarship Application

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Produced by LCCC Public Relations PRS 2293 6/15
Kay and Jerry Jessen
FAMILY SCHOLARSHIP
P.E.O. CHAPTER Z, CHEYENNE, WY
Application Deadline: June 1
Name Date
Student ID
Marital Status
S M D W
Address
Street
City, State, ZIP
Daytime Phone Number
Cell Number Birthdate
Dependent Children
(# if applicable)
Annual Income from all Sources
(Work, grants, scholarships, child support, etc.) $
Semesters
completed
Enrolled Full-time
Part-time
Major Cumulative
GPA
Educational History
Name(s) and Location(s) of High School and Colleges Attended Date Attended Diploma/Degree
1.
2.
3.
4.
Career Goal
For what purpose is aid desired
Attach a short description of yourself (1 page), how you are nancing your education and why you want a
degree. Include honors, achievements, community service, organizations.
Check the following to be sure the application package is complete
1. Application Form 2. HS/College transcripts 3. Biography 4. Two letters of recommendation
By checking this box, I hereby certify the provided information is accurate to the
best of my knowledge. I also certify that I will allow the Scholarship and Financial
Aid Office at LCCC to release any information that is applicable to this application.
Kay and Jerry Jessen
FAMILY SCHOLARSHIP
P.E.O. CHAPTER Z, CHEYENNE, WY
The Kay and Jerry Jessen Family Scholarship was established to assist a female,
non traditional student wishing to pursue further education. The monies are
awarded annually to a qualified applicant and will be administered by P.E.O.,
Chapter Z, Cheyenne, WY.
Applicant Name_________________________________________________ Date_________________
Eligibility:
• The applicant must be a female resident of the State of Wyoming.
• The applicant must possess a high school degree or equivalent.
• The applicant must be currently enrolled as an undergraduate and must have
completed at least one full time semester of college (12 or more credit hours
verified).
• The applicant must be enrolled as a full time student for the coming fall semester
at any of the LCCC campuses, Eastern Wyoming College, or the University of
Wyoming.
Application Requirements:
• All pages of the application form must be completely filled out.
• An official transcript or copy of an official college transcript attended must be
included. Transcripts generated by the student are not acceptable.
• The application must include a one page biography.
• Application materials must be received by the financial aid office no later than
June 1.
• Two letters of recommendation from non-family members are to be included.
Selection Criteria:
• All eligibility and application requirements requested above must be completed.
• Preference will be given to a single parent who is resuming or continuing her
education.
• Finalists will be selected and interviewed prior to final determination of the
award. Notification of interviews will take place prior to July 1st.
•
Selection of recipients if made by the Scholarship Committee, P.E.O.,
Chapter Z. Selection is based on the information provided by the applicant and
the personal interview.
• The allocated amount of the scholarship will be awarded for the fall semester by
the LCCC Foundation
Short description of yourself (1 page), how you are nancing your education and why you want a degree. Include honors,
achievements, community service, organizations.
Applicant Name_________________________________________________ Date_________________
1. ACADEMIC ACHIEVEMENTS
TOTALS
Applicant has a grade point average of:
2.5-2.9 = 1 pt.
3.5-above = 3 pts.
3.0-3.4 = 2 pts.
4.0 = 4 pts.
Applicant is/has carried the following class load
Less than 13 credit hrs = 1 pt.
Over 13 credit hrs = 2 pts.
Nursing students, 12 hrs. = 2 pts.
The degree of difficulty classes taken by the applicant are:
Adequate = 1 pt.
Challenging = 2 pts.
Very challenging/advanced = 3 pts.
Applicant has set appropriate and attainable educational goals:
No = 0 pts.
Yes = 1 pt.
Subtotal – Academic Achievements =
2. FINANCIAL NEED
TOTALS
Applicant has limited financial resources based on annual income from all
sources.
Over $15,000 = 2 pts.
$12,000-$15,000 = 3 pts.
Less than $12,000 = 5 pts.
Applicant has the following work load in addition to school:
Doesn’t work = 0 pts.
Works part-time = 1 pt.
Works full-time = 2 pts.
Applicant currently has significant outlays of income:
0 dependents = 1 pt.
1-2 dependents = 2 pts.
3 or more dependents = 3 pts.
Subtotal – Financial Need =
3. BIOGRAPHICAL INFORMATION
TOTALS
Applicant has received recognition for personal or scholastic excellence:
No honors = 0 pts.
Has received one or more honors = 2 pts.
Applicant is or has history of participation in civic, school or religious
organizations:
No participation = 0 pts.
One or more affiliations = 2 pts.
Applicant has typed her biography grammatically correct and free of spelling
errors, hopefully.
No = 0 pts.
Yes = 1 pt.
2 Extra points if student has shown determination
and resolve in pursuing goals Bonus Pts. =
Subtotal – Biographical Information =
APPLICATION SCORE =
0
0
0
0
0
Submission Instructions
Submit application before June 1.
Please note the pop-up window that appears after you click
Submit.
1. e window will ask you to select your email client.
2. If you use Microsoft Outlook Express, Microsoft
Outlook, Eudora or Mail, click “OK” in the pop-up
window. e form will be emailed to us.
3. If you use any other client, such as Yahoo or Hotmail,
choose “Internet Email,” then click “OK.”
• e computer will save the form to your hard drive.
• Open your email account.
• Attach the form to a message and email it to
FinancialAid@lccc.wy.edu.
4. Please contact Financial Aid at 307.778.1156 to make
sure the form was received successfully.
or
and mail to: Laramie County Community College
Scholarship & Financial Aid Oce
1400 E. College Drive
Cheyenne, WY 82007
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2293JessenFamily FORM Kay and Jerry Jessen Scholarship Application

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Completed 15 February 2020

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