Fillable December 11, 2013 Counselor, I am Lieutenant Commander (Florida Consortium of Public Charter Schools)

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December 11, 2013 Counselor, I am Lieutenant Commander (Florida Consortium of Public Charter Schools)

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Dedicated to leadership, diversity, retention, recruitment and professional development in the sea services
Counselor,
December 11, 2013
I am Lieutenant Commander Keith Dobbins, the Tidewater Chapter President of the National
Naval Officers Association (NNOA). Every year NNOA offers the Vice Admiral Samuel Gravely
Scholarship awards to qualified students entering their freshmen year of college. Vice Admiral
Gravely was distinguished as the first African-American to command a U.S. Navy warship, to be
promoted to flag rank and to command an entire Navy Fleet. In his honor, we award three scholarship
awards (one $2,500, one $1,500, and one $1,000) to Hampton Roads High School Seniors. It is my
pleasure to solicit your support in ensuring this information is disseminated to eligible students. To be
eligible for the Vice Admiral Samuel Gravely Scholarship, students must:
- Be a high school senior in the State of Virginia
- Have a Grade Point Average of 3.0 or better
- Have been accepted to attend a four-year degree program at an accredited college or university
- Complete the attached application with ALL required attachments, including a letter of
recommendation from a school official (teacher, guidance counselor, principal/assistant
principal)
- Complete an essay answering the following question
Essay Question: All students are faced with the decision of what to do after high school
graduation. Some students decide to enroll in college, while others go directly into the job
market. Briefly explain why you have decided to pursue the higher education pathway and
what you hope to accomplish in doing so.
The essay must be a minimum of 500 words typed, double-spaced and single-sided. We will
accept essays and applications post-marked or recevied via email not later than March 7,
2014.
Send completed applications packages via postage mail or electronically (preferred) to:
National Naval Officers Association, Tidewater Chapter
P.O. Box 454
Norfolk, VA 23501-0454
nnoatidewaterscholarships@gmail.com
NOTE: The award winners will be announced the first week of April 2014. All award recipients will be
recognized during a formal ceremony in May 2014. Awards will be sent to each college/university upon
verification of enrollment. Any questions may be addressed to LT Latanya Rose, Scholarship
Representative, at 757-953-3393 or latanya.rose@med.navy.mil.
Very Respectfully,
Lieutenant Commander Keith Dobbins
President, NNOA Tidewater Chapter
NATIONAL NAVAL OFFICERS ASSOCIATION
TIDEWATER CHAPTER
2014 VICE ADMIRAL SAMUEL L. GRAVELY SCHOLARSHIP APPLICATION
NAME (Last, First, MI)
Social Security Number
XXX-XX-
Applicant's Address
Applicant's Telephone Number w/Area Code
Name of Parent or Guardian
Parent/Guardian's Address
Parent/Guardian's Telephone Number w/Area Code
Name of High School
High School Address
High School Telephone w/Area Code
Graduation Date
Citizenship
U.S. Naturalized (give date )
Gender Male Female
Virginia Resident Yes No
Ethnic Background
Height Weight
Applicant's E-mail Address
Prior Military Experience (i.e. Junior Marines, Sea Cadets,
NJROTC. Include dates)
Choice of College or University
Page 1 of 3
Page 2 of 3
SCHOLASTIC ACTIVITIES
From grades 9-12, list academic honor societies and any related awards.
SOCIETY
EXTRACURRICULAR ACTIVITIES
Include NJROTC, Civil Air Patrol, school, church, scouts, and community organizations, etc.
ORGANIZATION
ATHLETIC ACTIVITIES
SPORT
POSITION / SPECIALTY
List other activities not mentioned above. Include only those that involve leadership, responsibility, or community service.
Attach additional sheets if needed.
COLLEGE BOARD RESULTS SAT Total Reading ACT composite
(attach copy of ACT/SACT scores) SAT: Writing Math ACT: English Math
SAT: Multi. Choice Essay ACT: Reading Science
CLASS RANK: CLASS SIZE: GPA: on a 4.0 scale
Page 3 of 3
ADDITIONAL INFORMATION
YES / NO
Have you ever applied for or signed an agreement concerning any program leading to a
commission in any of the armed services?
Have you ever gone by any other name than what you printed on this application?
Have you ever been arrested, summoned to court, detained, or convicted for any civil or
military law violations? Include moving violations and juvenile offenses.
Have you ever sniffed glue, used marijuana, LSD, cocaine, or any other controlled
substance or have you ever been charged with a drug-related offense?
Have you ever taken any narcotic, sedative, or tranquilizer other than those prescribed by
your physician or dentist?
If you answered "YES" to any of the above questions, please attach a statement on a separate sheet of paper.
ATTACHMENTS
In order to complete this application, please ensure you have attached the following:**
(1) A recent photograph of yourself (school picture or similar caliber, electronic submission preferred).
(2) Essay Question: All students are faced with the decision of what to do after high school graduation. Some students
decide to enroll in college, while others go directly into the job market. Briefly explain why you have decided to pursue the
higher education pathway and what you hope to accomplish in doing so.
(The essay must be a minimum of 500 words typed, double-spaced and single
sided)
(3) Letter of recommendation from school official referencing your motivation and aptitude to complete a 4yr degree.
(4) Copy of your college or university letter of acceptance.
(5) Copy of ACT or SAT results ("official" copy NOT required)
(6) Copy of high school transcript ("official" copy NOT required)
If you have prior college experience, attach copy of your transcript ("official" copy not
required)
(7) Additional or amplifying information to any questions on this application as required.
(8) Copy of awards listed on this application.
(9) Provide a brief statement (1-2 paragraphs) explaining why you would benefit from this scholarship. Ideas to consider
discussing are your plans for financing college education and current and foreseeable financial difficulties.
(10) Signed and dated Privacy Act Statement and Statement of Understanding (enclosed)
**NOTE: Although not required, electronic documentation submission is preferred (including required signatures).
READ AND SIGN
I understand that this application does not obligate me in any way and that I may withdraw my application at
that all information is complete and correct to the best of my knowledge under penalty of forfeiture of scholar
any time. I certify
ship benefits.
Signature Date
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Privacy Act Statement/Statement of Understanding
AUTHORITY: Title 10
U
.
S.
Code§§
5014 and
5020
PURPOSE: To determine the in the applicant is qualified for the scholarship purposes
on
ly
.
D
i
sclosure
of Last four of Social Security Number is
vo
l
untary,
and if requested, is used to further identify
the
i
ndividual
providing the information.
ROUTINE USES: The information is used for the purpose set forth above and if selected may
be:
- Forwarded to the College of University of the Applicants Choice
ONLY
:
THIS DISCLOSURE IS STRICTLY AND WILL NOT ADVERSELY EFFECT THE
APPLICANT
PROVIDING THE INFORMATION AND WILL BE USED FOR SHOLARSHIP PURPOSES ONLY
BY
NNOA TIDEWATER
CHAPTER.
ACKNOWLEDGMENT:
I
understand the provisions of the Privacy Act of 1974 as related to me through the foregoing
sta
t
ement.
Signature: ____________________________________________
Date: _______________
FOR OFFICIAL USE ONLY
-
PRIVACY
SENSATIVE
Any misuse or
unauthorized
disclosure may result in both civil and criminal
penalties.
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December 11, 2013 Counselor, I am Lieutenant Commander (Florida Consortium of Public Charter Schools)

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Completed 1 October 2021

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