Name
________________________________
Address
________________________________
Phone
Number
________________________________
|
Date of
birth
________________________________
City/Town
________________________________
Social Security
Number
________________________________
|
Name of High
School
________________________________
Address of
School
________________________________
Phone
Number
________________________________
|
Date of
Graduation
________________________________
City/Town
________________________________
|
Awards may be granted in the
following categories please select choice(s):
______ Outstanding Contribution in the Visual
Arts
______ Outstanding Contribution in Theatre and Dance
______
Outstanding Contribution in Vocal and Instrumental
______ Outstanding
Contribution in Creative Writer |
Applications must include this
application form and:
- 2 letters of recommendation from an adult
professional (non related), include phone numbers.
- A sample or description of your most
significant creative accomplishment(s). (May include: photographs, slides,
video/audio tapes, and/or writing samples)
- Essay (as described below.)
|
Send application
to:
Plumsted Township
Council for the Arts
Scholarship Committee
121 Evergreen Road
New Egypt, NJ 08533 |
|
Deadline for application is April 15, 2004.
Recipients will be notified by graduation.
Essay Requirements:
Essays
must be typed.
Please answer questions in detail on a separate piece of
paper:.
1.
Describe your specific talent and how it has evolved over your high school
career.
2. What impact did your outstanding achievement(s) have on your
school, family, community or work place? Describe any leadership roles you had
in the activity as founder, organizer, coordinator, spokesperson, etc.
3. How did your accomplishment(s) affect you personally? Describe how
you will use your talents in the future.
Signed
______________________________________ Date ________________ |
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