City of Hammond College Bound Application 2011 (New Applicant

)
(See reverse side for scholarship guidelines) -- 853-6502 Section I: Applicant information
First Name M.I. Last Name Social Security or ID Number (optional)

Street Number and Name

City

State

Zip Code

Phone Number

Email address (optional)

Parent(s)/Legal Guardian(s)

First Name

M.I.

Last Name

Natural Parent

Custodial Parent

First Name

M.I.

Last Name

Natural Parent

Custodial Parent

The applying student must reside with the parent(s)/legal guardian(s) who must be able to demonstrate proof of home ownership by attaching a copy of their homestead exemption to this application.

Section II: Starting Semester (indicate semester for which
you are requesting the scholarship)

Section III: Educational Plans: Indicate the name

Fall 201 ______ Spring 201 _______ Note: Summer sessions are excluded for purposes of this scholarship.
have applied for, including the anticipated award amount. Yes, I have completed the FASFA application (Due by 3/1/11) No, I have not completed the FASFA application

and location of the Indiana college or university that you plan on attending. Attach a letter of acceptance/admission to this application.

Name of College: _______________________ Location: ______________________________

Section IV: Other Scholarships/Financial Aid List all other scholarships or financial aid (FASFA) , except loans that you

Section V: High School Information
High School Attended: _____________________________________________________________________ SAT score (combined verbal and math only) _______________or Total SAT Score ____________________ or Composite ACT score ______________ Cumulative GPA: _________________ Signature of High School Counselor: _______________________________________________Date: ______ It is your responsibility to return your completed application with required attachments (proof of homestead exemption, college letter of acceptance/admission, proof of application for Financial Aid, and certified grades or SAT scores to: College Bound Scholarship Program Attn: Courtney Margraf 5925 Calumet Avenue – Suite #115 Hammond, IN 46320 FOR OFFICE USE ONLY: Received ________________ Approved/Denied _________________ Sent letter ________________________ Notes _____________________________________________________________________________________

0 or higher from an accredited public or private high school. and a letter of college acceptance/admissions.gohammond. Be enrolled in college credit producing courses and in a degree-seeking program after his/her first year of study. Basic & Performance Eligibility (See www.P. 2011. The scholarship is available to eligible students for 4 consecutive years within a 5 year timeframe.Eligible for up to the entire 100% scholarship amount. Students who completed their high school education through home-schooling are required to file an exception in order to be eligible to participate in the College Bound program. Home-schooled students may apply for the scholarship through the program’s exception process. and disclose all scholarships and aid to the College Bound Scholarship Program. or other information from my high school or university necessary to process my application. proof of financial aid. • 8th to 12th grade. • 10th to 12th grade. I have attached proof of home ownership (homestead exemption). It is the responsibility of the applicant to submit this application to the College Bound Program on or before July 1. or a total score of 1400 on the Scholastic Achievement Test (SAT). Bring proof of FAFSA. __________________________________________ Student Signature Date ___________________________________________ Parent Signature Date . Should you become ineligible.Eligible for up to 90% of the scholarship amount. disclosure of all other scholarships.P. and parental home ownership. Provide a detailed account of all scholarships and financial aid received including the source and amount of such awards (See Section IV). Award notifications are sent within 3 weeks of receiving the application. of 2. and a G. All students of a Hammond homeowner who attend an accredited high school outside of Hammond are eligible for up to 100% of the scholarship providing they meet all other scholarship eligibility requirements (including a valid homestead exemption).The amount of scholarship award will be determined by the number of years that the student has lived in a home owned by that student’s parent(s) or legal guardian(s) in Hammond: • 6th to 12th grade.A.0 cumulative grade point average (measured on an annual basis) during four consecutive years of college and release those grades to the College Bound program. Begin college studies within 16 months of graduation from high school. Proof of a Homestead Exemption can be obtained from the: Lake County Auditor’s Office . regardless of eligibility for such assistance. I understand that a list will be made publicly listing all recipients. Demonstrate that you live in an owner-occupied home within Hammond City limits. Your parents/legal guardian(s) must continue to live and maintain home ownership in Hammond (monitored through proof of a homestead exemption) until you complete your fourth year of college.Application Deadline If you are a first time applicant you are encouraged to apply as early as possible for this scholarship but by no later than July 1. Provide proof of legal guardianship in those situations where a natural parent is not the legal guardian. Failure to meet the requirements of the College Bound program will result in the loss of eligibility. I hereby authorize representatives of the City of Hammond’s College Bound Scholarship Program to receive academic information. The student must perform up to 40 hours of community service per year as assigned by the College Bound Program.A.Eligible for up to 70% of the scholarship amount. Amount of Scholarship. Provide a letter of acceptance/admission to an accredited Indiana based public or private college or university. you may not rejoin or restart participation in the College Bound program. The scholarship will be immediately cancelled should your parents/legal guardian(s) move out of the City.) of 3. subject to the schedule above. • 9th to 12th grade.5 will also be considered eligible for the scholarship. and provide the program with a copy of his/her most current grade transcripts and proof of residency. 2011. grade transcripts. Students who achieve a score of at least 1. amount received and the college/university attended. Proof of home ownership for the purposes of College Bound will require that the parent or legal guardian own a home with a current homestead exemption.000 (Math & verbal combined).com for full details on eligibility): • • • • • • • • • Complete and sign this application. or 21 on the ACT. Maintain at least a 2. An interruption in the student’s college education lasting more than one semester shall be cause for ineligibility. Bring College Bound your official transcripts from high school. Complete an application for financial aid (FAFSA) by the Indiana deadline date (Due by 3/1/11). • 7th to 12th grade. Attend any accredited public or private school (see “Amount of Scholarship” below for details).219 755-3120.Eligible for up to 80% of the scholarship amount. Continuing Eligibility • • • • • • • • Authorization of Release of Records and Acknowledgment of Program Requirements Reapply each year by July 1st.Eligible for up to 60% of the scholarship amount. Graduate with a cumulative grade point average (G.