Scholarship Applications

Judge C. C. Chavelle Foundation
Scholarship Application
Please complete the Collowing inCormation to be used Cor
evaluation by the trustee's.
The Judge C. C. Chavelle Foundation
pledges all scholarships annually in August.
Complete application Cormpacket and return to address below.
Name:
Date:
Permanent mailing street address:
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City -----------------State
Telephone:
Zip
_
Social Security No
_
Date and place of birth:
Name of school applicant will be attending:
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Mailing address of school: (funds are mailed to school)
Dates of quarter or semester terms:
Student ID number:
Test Scores and Grade Point Averages
College Entrance Examination Board Scholastic Aptitude Test
S. A. T. Scores:
_________________
Verbal:
_
Math:
_
Other pre-college test scores: Verbal: ------'Quantitative:
Cumulative grade point average (4.00 scale):
High School/ College most recently attended:
Address:
Years:
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_
Class Ranking
Honors and Awards
Offices and Positions of Leadership
School or Community Activities
Required additional information to be completed and returned
with application for consideration:
1) Applicant's Statement - Limit 300 words
2) Employment History - Limit one page
3) Addresses and telephone numbers of not more than three
references:
4) Copy of certified birth certificate
Applicants must have been born in the State of Washington to be eligible.
5) Copy of letter of acceptance from institution applicant will be
attending
6) If you are reapplying for scholarship assistance include a complete
application packet and the year end transcript from the institution
a licant attends.
Certificate and Release Authorization
I certify that this information is true, complete and accurate. I
authorize release of information to confirm and/ or verify this application. I
understand that if a scholarship is awarded to me, it will be paid directly to
the institution and credited to my account; and I agree to acknowledge for
publication that the scholarship was awarded to me by the Judge C. C.
Chavelle Foundation.
Applicant's Signature
Mail application to:
Judge C. C. Chavelle Foundation
P. O. Box 4742
Rolling Bay, WA 98061-0742
www.chavelle.org
Date
[Type text]
JUDGE C.C. CHA VELLE FOUNDATION
SCHOLARSHIP POLICY
The Foundation may at its discretion establish criteria by which scholarships are
awarded to 1) graduates of high school, 2) who are born in Washington State, and 3) who
will be attending a vocational institute, university or college. The Foundation shall
establish clear, objective criteria of eligibility for scholarships, and for ranking the
eligible students for those scholarships.
Application for scholarships must be postmarked after January 1 and before June
1 of the year they graduate. Incomplete applications will not be considered eligible for
scholarships.
Students must meet the Foundation's criteria, and make complete application for
the scholarship. A complete application packet includes 1) the application form, 2) an
applicant's statement, 3) employment history, 4) contact information for three references,
5) a copy of a certified birth certificate of the applicant and 6) a copy of the acceptance
letter from the institution applicant will be attending, and a 7) complete copy of their
most recent high school transcript.
Applications for the continuation of scholarships will include a complete
application packet as outlined above, plus 8) the year's end transcript from the institution
the applicant attends.
Recipients of Chavelle Foundation scholarships or continuation scholarships will
receive notice no later than August 15 of each calendar year by US mail. All scholarship
funds, including those to be applied to tuition, textbooks and on-campus or school
operated housing, are paid directly to the institution designated on the students'
applications.
Any portion of scholarship funds not used during the scholastic year of the
designated scholarship must be returned to the Chavelle Foundation, not to the student.
Failure to comply with these terms will require the scholarship recipient to repay the
Foundation for the entire scholarship. Random reviews of the scholarship amounts used,
details of how it was used and confirmation that student completed their courses will be
held at the discretion of the Foundation.