Fillable Form 1185 Scholarship Information And Application (City of BIsmarck)

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Form 1185 Scholarship Information And Application (City of BIsmarck)

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Last modified 1/20/2020 1
The Bismarck-Mandan Mayors’ Committee for People with Disabilities
Scholarship Application
Dear Educator/Counselor/Agency Personnel,
The Bismarck-Mandan Mayors’ Committee was formed in 1964. We are a volunteer
organization comprised of school personnel, vocational rehabilitation, advocacy organizations,
non-profit agencies, city personnel and the private sector. The mission of this committee is to
endorse and promote the hiring of people with disabilities, endorse and promote accessibility
within our communities and encourage and coordinate open communication related to the issues
of employment of persons with disabilities. The committee currently operates with funds
received from the cities of Bismarck and Mandan from their handicap parking violations.
Through the Scholarship Committee, the Bismarck-Mandan Mayors’ Committee solicits and
awards scholarships to persons with disabilities pursuing post-secondary education, which also
includes vocational training. The committee will be awarding up to five scholarships in the
amount of $1000.00 to students in the Bismarck-Mandan area this year. Awards are contingent
on available funding.
Attached is the Scholarship Application Form to be completed by each applicant. The application
must be completed in its entirety and returned NO LATER than April 24, 2020 to be considered.
A former applicant can re-apply if they are (1) maintaining 12 hours minimum per semester, (2)
complete and send in this application and by (3) explaining to the committee how will reapplying
for this scholarship help reach your career/educational goals.
Please email the completed application to maryr@dakotacil.org (title of email: SCHOLARSHIP)
or mail to:
Bismarck-Mandan Mayors’ Committee for People with Disabilities
c/o Mary Robinson
3111 East Broadway Ave
Bismarck, N.D. 58501
Awards will be announced no later than May 31, 2020.
By submitting this application you are giving the Bismarck-Mandan Mayors’ Committee for
People with Disabilities the right to provide your name, your disability, education status and all
other information shared in this application with other committee members. Those applicants
that are selected to receive this scholarship may be used for media purposes.
For questions contact Mary Robinson at 222-3636 or maryr@dakotacil.org.
The Bismarck-Mandan Mayors’ Committee for People with Disabilities
Scholarship Application
Last modified 1/20/2020 2
Policy Statement
In an effort to support students who are planning to attend a college, university, vocational
training program, or other post-secondary training organization, the BMMCPD may award
scholarships on a yearly basis. The amount of each award and the number of awards given will
be determined on a yearly basis by the Mayors’ Committee, depending upon available funds.
The Use of Financial Assistance Monies
Many students with disabilities are challenged to meet the high cost of their education-related
expenses. Adaptive technology, computers, interpreters, or readers in addition to tuition, books
and housing are all qualifying expenses for the purpose of this assistance.
Qualifying Criteria to make application for Financial Assistance
Any student with a qualifying disability who is a graduate of a Bismarck-Mandan area high
school, or has obtained their GED, is eligible to apply. Students who are in their final year of
high school and submitting post-secondary application will also be considered.
Requirements to be eligible for the scholarship award are:
• A qualifying disability as defined by the Individuals with Disabilities Education Act;
Section 504 of the Rehabilitation Act; or the Americans with Disabilities Act will be used
as criteria for consideration.
• Applicant must be a United States Citizen.
• Applicants must have been accepted for enrollment to a college, university, trade school,
vocational training program, or other post-secondary training as defined by the
educational institution; before the scholarship award can be disbursed.
• Applicants will be selected on the basis of the essay, financial need, application content
and academic merit. Letters of recommendation from faculty, employers or community
leaders and extracurricular school activities, community involvement and examples of
leadership are favorable consideration for applicants.
Financial awards will be mailed directly to the Institution unless otherwise indicated in the
award letter. Awards will not be payable to the award winner.
Committee Responsibilities:
• Prepare the annual announcement of scholarship applications and distribute to area high
schools, colleges and universities, vocational rehabilitation and other providers.
• Establish annual deadline dates for applications.
• Review applications and determine eligibility based on criteria listed.
• Notify the award recipient(s) by mail.
The Bismarck-Mandan Mayors’ Committee for People with Disabilities
Scholarship Application
Last modified 1/20/2020 3
Applicant Responsibilities
• Applications that include all required documentation in a neat and orderly manner will be
given priority consideration.
• Demonstrated commitment to community involvement through your church, by
volunteering, helping out a neighbor, leadership skills is also a plus when considering
applicants.
• Financial needs will also be considered by the selection committee.
Applicant Checklist
1. Applicant is a graduate or student of a Bismarck-Mandan School .
2. Documentation of Disability is included in application .
3. High School Transcripts have been sent .
4. Student ID number is included (If you have not received your letter of acceptance,
it is your responsibility to provide the selection committee with a copy of this as soon as
possible.) Funding will not be provided until this is provided.
5. Two letters of recommendations are enclosed . Letters can be from teachers/other
school personnel, your employer, pastor, community member; family friend (excludes
family members).
6. Your application clearly states what the funds will be used for
7. Your personal essay is enclosed . (Your application will not be considered without
the essay).
The Bismarck-Mandan Mayors’ Committee for People with Disabilities
Scholarship Application
Last modified 1/20/2020 4
Last Name: First Name: Middle Initial:
Email address (if desire):
Home address:
Mailing address (if different than stated above):
City: State: Zip Code:
Phone number (include area code):
Are you a U.S. citizen? (select one):
Yes No
EDUCATION:
Name of high school:
Date of graduation or completion:
NOTE: A copy of the high school transcript should be included with the application, if still
available from the school. If too much time has elapsed to secure this information, please let
us know how we can confirm the above information.
(Name / phone number / area code of school):
I currently hold (check all that apply):
High School Diploma / GED
Certificate of Completion
Some College, (number of semester hours )
Associate’s Degree
Bachelor’s Degree
Master’s Degree
Are you currently attending a college or other post-secondary school? (select one):
Yes, if yes, where? (include name and address)
No
The Bismarck-Mandan Mayors’ Committee for People with Disabilities
Scholarship Application
Last modified 1/20/2020 5
Have you applied for financial aid?
Yes, if yes, from
where? No
How will this scholarship award be used? (Be specific, examples would include books or
tuition, adaptive equipment or other). The award CANNOT go for both tuition and books.
Describe your education or vocational goal. What type of career do you want?
Name the post-secondary school or vocational center you plan on attending:
Address of where the check should be sent:
Zip Code:
Phone Number:
(Please call the school to confirm where the checks should be sent. Tuition checks are
usually sent to Student Account Services, which is a different address from the school)
The Bismarck-Mandan Mayors’ Committee for People with Disabilities
Scholarship Application
Last modified 1/20/2020 6
Student ID#
(Many colleges have requested we add the ID# to ensure proper credit)
How many credit will you be taking each semester?
If you have been accepted; what date will your first class start on?
If you have NOT been accepted at this time, it is your responsibility to notify the Bismarck-
Mandan Mayors’ Committee for People with Disabilities when you are accepted.
Disclosure of your disability is needed for eligibility purposes OR Documentation of your
disability will be accepted.
State any financial need that you may want the Bismarck-Mandan Mayors’ Committee for
People with Disabilities to consider.
Self-Essay (Required for eligibility)
On a separate sheet, please describe in your own words your personal and educational
achievements. Include any involvement in extracurricular school activities, community or
volunteer activities, work experience, and examples of leadership. Address your disability, how
has it challenged you or motivated you in your life. What is your ultimate goal? Why should the
selection committee choose you? Your essay should not exceed more than 500 words. If an
accommodation is required, essays may be submitted in an alternate format (i.e.: Braille,
diskette, tape).
For former applicants ONLY-(1) need documentation that you are maintaining a minimum of 12
hours per semester (2) Your essay should include “How did the previous funding help you and
how will your selection for the second time help you reach your career goal(s)?”
The Bismarck-Mandan Mayors’ Committee for People with Disabilities
Scholarship Application
Last modified 1/20/2020 7
I acknowledge that the enclosed information is true and correct. I understand that failure to be
enrolled in the post-secondary school or training program listed in my application will result in
forfeiture of this scholarship. I also understand that the Bismarck-Mandan Mayors’ Committee
for People with Disabilities will verify my enrollment in the school prior to the issuance of the
scholarship award.
__________________________________
Signature of Applicant Date
Completed scholarship applications with supporting documentation (applicant’s
guidelines) must be post marked on or before April 24, 2020 in order to be considered.
Email completed scholarship applications to maryr@dakotacil.org (title of email:
SCHOLARSHIP) or mail to:
The Bismarck-Mandan Mayors’ Committee for People with Disabilities
c/o Mary Robinson
3111 East Broadway Ave
Bismarck, N.D. 58501
Priority will be given to Bismarck-Mandan graduates.
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Form 1185 Scholarship Information And Application (City of BIsmarck)

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Completed 14 July 2020

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