Utah Elks Association Vocational Grant Application

Utah Elks Association

Application of Required Facts

VOCATIONAL GRANT PROGRAM
IMPORTANT. Read the instructions on Page 5 carefully. Incomplete applications will not be processed.

Name___________________________________________________________________________ Social Security # __________________________

Street Address_____________________________________________________________________________ Phone (___)_____________________
Area Code / Number
City/State/Zip ____________________________________________________________________________________________________________

Date of Birth _____________________ Place of Birth______________________________________________Age____________Sex____________

Citizen - US American Yes . No . (Applicant must be citizen on date application is signed. If not born an American citizen, give date and place of Naturalization.)

Date_________________________Place ____________________________________________________ # ________________________________

City / State

Name of High School Attended . or now attending . ________________________________________________________________________

Address __________________________________________________________________Year will Graduate__________or Year Graduated______
Grade Point Average (GPA)_________________________________ Did not & will not graduate from High School __________________________
I am not a High School graduate, but I have received my G.E.D. Yes . No .
Detail educational background listing all Vocational./Technical Schools/Colleges or other Schools, beyond high school level, attended or attending and degree attained, if any.
School Name/Address Dates Degree/Certificate
____________________________________________ ________________ ________________________________________________________
____________________________________________ ________________ ________________________________________________________
____________________________________________ _________________ ________________________________________________________

I certify that the statements contained in this application are true.
Date: ___________________________________________ ___________________________________________________________________
Signature of Student

MUST HAVE ENDORSEMENT OF A LODGE OF THE B.P.O. ELKS OF THE U.S.A.
TO BE ACCEPTED FOR JUDGING
The Scholarship Chairman or Exalted Ruler or Secretary of the B.P.O. Elks Lodge, in the jurisdiction where the applicant is resident, must sign the Lodge endorsement certifying that he has reviewed the application. Applications should not be endorsed if they do not essentially conform to the requirements outlined in this Application of Required Facts. Applicant must use official Utah Elks Association form .
This application, with attached exhibits, has been reviewed and conforms to the rules and regulations set forth by the Utah Elks Association Scholarship Committee.

Lodge Name:_________________________________________No._______ State:____________________

Date:________________________ (signed)________________________________________________________________________________
Lodge Scholarship Chairman or Exalted Ruler or Secretary

TO LODGE PERSONNEL: Applicant must file no later than the due date of the MVS program of year applied. After endorsing the application, mail it to: Utah Elks Association Youth Activities Committee Chair, to be postmarked no later than February 5, year applied. Applications post-marked after February 5 will not be accepted.

College or Vocational School planning to attend ______________________________________________________________
(Full Name NOT initials)
Address________________________________________________________________________________________________
Street address
First year - Date course will begin ___________________ Date course will end __________________________________________
Month / Year Month / Year
Second year - Date course will begin _________________ Date course will end __________________________________________
Month / Year Month / Year
Vocational Goal (Give name of course of study) _______________________________________________________________

At completion of this course, I will receive a Certificate _____ Diploma _____ or a ______________ Degree (type of Degree)
Is this a 2-year course Yes . No . If not, how long is course _________________________________________
Do you plan to continue on to a 4-year degree? Yes . No . Undecided .
Employment record (employer, address, dates of employment, person to contact about employment, position):
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________

Honors & Awards - Non-school related (Civic):
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

Offices or Positions held (Organization, position, year)
_______________________________________________________________________________________________________________
________________________________________________________________________________________________________________

Other Activities (School or Civic)

_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________

TO BE COMPLETED BY ALL APPLICANTS
Budget for one full Academic Year. How many months ___________________

This grant can be used only to cover the items in A - B&C below. It may not be used for general living expenses such as apartment rent, mortgage payments, automobile expenses for use or maintenance of a car. It may not be used for child care costs. Incomplete or unnecessary information in this section can not be evaluated.

A. Tuition and Fees (full academic year, not monthly)

$____________________

B. Books and Supplies

$____________________

C. Room and Board (only if living on campus)

$____________________

D. Total of above - Add lines A., B. & C

$____________________

LESS ANTICIPATED AMOUNTS AVAILABLE FOR EDUCATION (INCOME):
E. Parent(s) Contribution

$____________________

F. Student's Contribution

$____________________

G. Summer Earnings

$____________________

H. College Work/Study Employment

$____________________

L. Other Scholarships, Grants or Loans (List name & amounts in detail):___________________________________________
___________________________________________________________________________________________________
J. Total of above - ADD lines E., F., G., H. & I

$____________________

Amount, needed to balance school budget for one year

$____________________

SUBTRACT line J. from line D

$____________________

This is an assistance grant and is NOT intended to cover the full cost of your eduction.-It is the responsibility of the student to also seek assistance from other sources and to demonstrate that the amount not covered by this grant can be obtained through personal or parental contribution or.through other sources of assistance programs.

To properly evaluate this application, the information on these 2 pages is essential. Choose the area which best fits the applicant's circumstances. A dependent applicant is one who relies on his/her parents for the basic & major portion of his/her support. An independent applicant is one on his/her own and derives the basic and major portion of his/her support from himself/herself and/or a spouse. Incomplete information in this area will disqualify applicant.

TO BE COMPLETED BY UNMARRIED APPLICANT DEPENDENT ON PARENTS:

Father's name Age: Occupation

Mother's name Age: Occupation

Parents marital status-Mother: Married Widowed Divorced Remarried

Father: Married Widowed Divorced Remarried

Father's annual income before taxes

Mother's annual income before taxes

Applicant's annual income before taxes

All other taxable or non-taxable income not included above (including pensions,
Social Security/disability, interest, dividends, etc. - explain source)

GROSS INCOME (total of above)

Number of Dependents (excluding mother & father)

Number of Dependents attending college in this academic year

Previous calendar year's Medical & Dental expenses not paid by insurance

Emergency expenses (flood damage, etc.)

Total market value of home $ Amount of unpaid mortgage

If no home is owned - amount of annual rent

Do you own a business or farm (Y/N) If so, what is market value

What is the net profit?

Value of bank accounts

Value of other investments (CD's, stocks, bonds, etc. - explain source):

Any unusual circumstance, please explain:

Does Mother or Father have a pension plan other than Social Security? Yes _____ No _______

TO BE COMPLETED BY MARRIED OR INDEPENDENT STUDENT.
    Applicant's marital status - Single _________ Married _______________
    Spouse's name____________________________________Age: ___________ Occupation ___________________
    Applicant's annual income before taxes

$_________________

Spouse's annual income before taxes

$_________________

All other taxable or non-taxable income not included above (including Social Security disability, interest, dividends, etc. - explain source)
___________________________________________________________________________________________
___________________________________________________________________________________________

$_________________

GROSS INCOME (total of above)

$_________________

Number of Dependents (excluding mother & father) ________________
Spouse attending school (Y/N) ________
Number of other Dependents attending School/College ______________
Previous calendar year's Medical & Dental expenses not paid by insurance

$_________________

Emergency expenses (flood damage, etc.)

$_________________

Total market value of home $ ____________ Amount of unpaid mortgage

$_________________

If no home is owned - amount of annual rent

$_________________

Do you own a business or farm (Y/N) __________ If so, what is market value

$_________________

What is the net profit?

$_________________

Value of bank accounts

$_________________

Value of other investments (CD's, stocks, bonds, etc. - explain source):

$_________________

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

Any unusual circumstance, please explain:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

ELKS NATIONAL FOUNDATION

Vocational Grant Program
WHO MAY APPLY: Any prospective student (male or female), resident within the jurisdiction of the Benevolent and Protective Order of the Elks of the U.S.A., who plans to pursue an eligible vocational/technical course. above and supplemental to high school or preparatory school level, may file an application. All applicants must be citizens of the United States of America on the date the application is filed. This application must be filed with the Lodge Scholarship Chairman or Exalted Ruler or Secretary of the B.P.O. Elks Lodge having jurisdiction in the area in which the student has legal residence, on or before the due date of the MVS Scholarship Program, year applied (for year 2004,that was Jan 9). Only one application may be filed and must be filed with the Lodge of jurisdiction.

The definition of an eligible program shall be comparable to that contained in the federal vocational legislation. It is defined as a two-year or less vocational/technical program, culminating in an associate degree, diploma or certificate, but less than a baccalaureate program (Bachelors Degree). A student must plan to carry a minimum load of 12 semester credit hours each term. Persons enrolling in a 4-year course leading to a Bachelor's degree are not eligible to apply. Do not apply if you are only a High School Junior as these grants are to be used in the next academic year only. This grant may not be used for part-time study or night-school.

Do not apply if you are planning to pursue an Associate Degree course which is a stepping stone to a 4-year Bachelor's profession. An eligible Associate Degree is considered a terminal Associate Degree, whereby, after 2 years of study, a student may become gainfully employed in his/her chosen vocational career. A student who is planning to continue toward a Bachelor's degree is not eligible to apply.

This Vocational Grant is for two years only and is not renewable. It is subject to review prior to the start of each academic year. Unexpended credit is subject to withdrawal, if conduct of the student is contrary to principles of law and order and morality supported by the Order of Elks. A student cannot accept more than one Utah Elks Association scholarship in any one academic year.

All scholarships are in the form of Certificates of Award issued by the Utah Elks Association conditioned upon the enrollment of the student in a vocational/technical course of a two-year US American College or vocational/technical school. Upon receipt of "Verification of Enrollment" form, completed by the proper school officials, a Utah Elks Association check in the amount of the grant will be forwarded to the school to establish a credit for the student, for the next academic year. Payments may not be used to cover retroactive charges. This award will not cover payments for any academic year begun prior to April 1, year applied Verification of Enrollment form will be provided for the academic year. If you are already in your 1st year of a 2 year course, you will be eligible for one-year only.

The grant may be used for tuition fees, room and board (only if living on campus) and books and supplies. It may be used only for usual and required costs of applicant's planned course of study. It may not be used for general living expenses such as apartment rent, mortgage payments, automobile expenses for use or maintenance of a car. It may not be used for child care costs.

Applicants are evaluated based on the information herein. Therefore, if, after being notified of a grant, course of study and/or school attending change, the grant may be withdrawn.

After completing this application, make a photo-copy for your own records.

Incomplete applications will not be considered for assistance. It is imperative that all information be set forth, especially information as to your costs to attend your chosen course, so that we may evaluate your needs.

Applications which are not endorsed by an authorized lodge of the Grand Lodge B.P.O. Elks of the U.S.A. will be re to the applicant.

All applicants will bo notified by May 15, as to whether or not they are to receive one of the two grants.

All applications become the property of the Utah Elks Association.

GENERAL INSTRUCTIONS
BROCHURE PREPARATION AND REQUIREMENTS
1. APPLICATION: Applicant must use the official Utah Elks Association form (no photocopies accepted), which has been dated and signed by the applicant and the Lodge official(s). Typewritten applications and statements are preferred over handwritten submissions and must be signed in all instances.
Applications and all supporting documents must be in English or English translations.
Letters must be originals, on one side of a single sheet of 8 1/2 x I I inch paper, and signed by the author.
2. EXHIBITS: Should be neat, concise and in chronological order. Letters of endorsement, etc., should be removed from envelope and bound flat (allow sufficient margin on left border for readability).
3. ORDER OF EXHIBITS:
A. Application - completed.
B. A statement by the applicant of not more than 200 words, summarizing his or her activities, accomplishments, needs and objectives, which the applicant thinks qualifies him or her for a grant, and outline career goals and course planned.
C. A letter of not over 150 words from a parent or other person having knowledge of the facts, presenting a picture of the family situation and showing the applicant's family background, (such as number of children in family, number of children still at home, and any information to establish factors judged under Judging Standards).
D. A brief letter of endorsement from a responsible person, not related to the applicant, other than an educator, who has had an opportunity personally to observe the applicant and who can give a worthwhile opinion of the character, industry, disposition and general w a of the applicant. Additional letters may be included, if appropriate and desired, but not more than two additional letters.
E. Letters from educators - not more than two. Letter(s) may cover the applicant's ability, work habits, leadership, personality and integrity.
F. Grade record or work record previous two years. (Armed Forces, Vocational, Aptitude test scored, may also be included).
G. Any other information which you feel will be helpful in judging your worthiness for a grant.
H. Applications must be properly bound on left side with hinges or staples in a rd binder or cover. Elaborate bindings are discouraged. Clear plastic or bulky covers are undesirable.
JUDGING WILL BE FOR THE FOLLOWING:
1. MOTIVATION - General worthiness, desire.
2. NEED - Financial need, resourcefulness.
3. SKILLS - Showing of good aptitude toward chosen vocation.
4. GRADES - High School, Vocation School, College, other test scores, etc.
5. BROCHURE - Completeness, neatness and the following of directions.
IMPORTANT: Be sure your brochure is in the hands of the sponsoring Elks Lodge Chairman prior to the established deadline date. Brochures received after this date cannot be accepted.

Utah Elks
Association

VOCATIONAL GRANT PROGRAM
Filing date: Due Date of the ENF MVS Scholarship Program

APPLICATION CHECKLIST

    . Original application, typewritten, signed and all questions answered.
    . BPO Elks Lodge endorsement.
    . Endorsement letters as required.
    . Transcript of grades or work record.
    . Budget for Academic year completed.
    . Appropriate financial page completed - page 3 or 4.
    . Turn page 4/5 back before stapling, so that pages 5 & 6 cannot be seen.

APPLICATIONS RECEIVED WITHOUT ENDORSEMENT LETTERS, GRADES, FINANCIAL
AND BUDGET INFORMATION AND/OR LODGE ENDORSEMENT, WILL NOT BE ACCEPTED.