Sussex County Superintendent Roundtable Association

Scholarship Application

Directions: Complete the questions below in full. Responses should be typed, well thought
out and inclusive of all information to be reviewed.

Student Name: ________________________________ School:__________________________

Address: ______________________________________ Phone:__________________________

_______________________________________ Email_________________________

Student Signature_______________________________ Parent Signature________________

1. List high school activities (student government, sports, publications, school-sponsored

community service programs, educational activities, arts, music, etc.).

High School Activity Dates Offices

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

2. List public service and community activities (tutoring, Girl/Boy Scouts, homeless services,
environmental protection/conservation, advocacy activities, work with religious
organizations, etc

Activity Dates Role

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

3. List part-time employment that you have held during high school years.

Type of Work Employer Dates Average # of Hours/Week

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. List awards, scholarships, publications or special recognitions you have received.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

5. Describe one specific example of your leadership. (250 words or less)

4. Describe a recent particularly satisfying community service activity that you participated in
that may have included working with children. (250 words or less)

5. Describe how you would like to contribute to the field of public education after you receive
your educational degree. (500 words or less)

6. What are the three most significant courses you have taken in preparation for your career in
the field of education and why do you believe they were the most significant?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

7. Describe the education program you intend to pursue.

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

8. What additional personal information do you wish to share with the Sussex County
Superintendent’s Committee in reference to why you should be selected our scholarship
candidate?
 Sussex County Superintendent Roundtable Association
Scholarship Announcement

Sussex County Superintendent Roundtable has announced that a $1000.00 scholarship for
the 2017-2018 school year will be awarded to a student in Sussex County that meets the
following criteria.

Criteria:
 Must be a Sussex County High School Student, pursuing a PT/FT post-secondary
education in a career in the field of education at a 2 year/4 year accredited
institution.
 Should be a student who has demonstrated character traits that reflect a good
attitude, attendance record, community involved, good work ethic and academic
record.
 Include 2 Letters of Recommendation from a person who can attest to your
responses to the above questions. (Teacher, Coach, Community Service Mentor,
Clergy, Employer)
 Include High School Transcript
 Include a list of Colleges/Universities that you have applied to or have an
Acceptance Letter that details your acceptance into a program that will lead to
future employment/ certification/licensure in the field of education. (Candidate may
need to share how the particular college/university will lead to future employment in
field of education. Field of education includes teachers and all related service fields-
such as Speech/OT/PT/Counselor)

Funding has been made possible for this scholarship through the Sussex County
Superintendent’s Roundtable Association, inclusive of all Public Schools in Sussex County.
A committee made up of current Sussex County Superintendents’ (or officers) will review
the criteria, the scholarship candidate’s responses and select based on a 5 pt. rubric scale.

Applications are available through the guidance departments of all high schools in Sussex
County or can be found online at www.sussexesc.org.

Applications can be sent to: Andrea Romano, 18 Gail Court, Sparta, NJ 07871
Application Deadline: March 30, 2018 by 3:00pm. No exceptions.