1 Scholarship Application Chamber630 (formerly the Woodridge

Scholarship Application
Chamber630 (formerly the Woodridge and Downers Grove Area Chambers) is proud to
offer scholarships to graduating High School Seniors who are furthering their education
at a technical or trade school, business college or a two or four-year college or
university. The amount awarded may be from $500 - $2500. Scholarship winners will
be recognized at a student luncheon on May 13, 2015. Applicants must be a
Chamber630 Member or a child of an owner or employee of a Member business in
good standing.
A completed application will include the following:
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All information legibly completed on the three page application form
Guidance Counselor signature on application form
Essay (maximum of 200 words)
One sealed letter of recommendation from a teacher.
Please print or type your application. Illegible or sloppy applications will be rejected.
Applications must be sent to Chamber630, 5 Plaza Drive, Suite 212, Woodridge, IL
60517 postmarked no later than Monday, March 16, 2015.
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_______________________________________________________________
Applicant Name
_______________________________________________________________
Address
_______________________________________________________________
_______________________________________________________________
Phone
_______________________________________________________________
Parent/Guardian Name(s)
_______________________________________________________________
High School
_______________________________________________________________
Affiliate Chamber630 Member Business and your association with the business (i.e., daughter/son of
employee – include name of employee)
I, ____________________________________________, as a Guidance Counselor at
Name
______________________________________________, certify that the above named
High School
student is receiving passing grades and is not in danger of failing.
______________________________________________
Guidance Counselor Signature
Application Checklist:
___All information is legible and complete on the application form
___Guidance Counselor‘s signature is on the application form
___Essay is attached and no longer than 200 words
___A sealed letter of recommendation from a teacher is enclosed
I certify that all information provided in this application is true and correct.
Applicant Signature
FOR OFFICE USE ONLY
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Date Received ____________
Number __________
Educational Plans
What is your anticipated major or focus at College/Tech School?
Is there another area of study you are interested in?
_______________________________________________________
List the schools you have applied to:
1. __________________________________________________
2. __________________________________________________
3. __________________________________________________
4. __________________________________________________
List all schools to which you have been accepted:
1. __________________________________________________
2. __________________________________________________
3. __________________________________________________
4. __________________________________________________
Have you applied for other Grants/Scholarships? (Please list them)
1. __________________________________________________
2. __________________________________________________
3. __________________________________________________
What else have you done to help finance or further your education?
______________________________________________________________________
______________________________________________________________________
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Extra Curricular Activities
Please list all High School activities (Athletics, Clubs, etc.) Include any leadership role(s) you have taken,
(offices held, awards/honors, etc.). Attach a separate sheet if necessary.
Name of Club/Organization
______________________
Year of Participation
__________
Leadership Role (if any)
___________________
______________________
__________
___________________
______________________
__________
___________________
Volunteer/Community Activity (Describe)
Advisor’s Name & Number
________________________________
________________________________
_________________________________
________________________________
_________________________________
________________________________
Please list any work experience.
Name of Company and Type of Work
Name and Number of Employer
_________________________________
________________________________
_________________________________
________________________________
_________________________________
________________________________
Please list any awards, published materials, or special recognitions you have received.
_________________________________
______________________________
_________________________________
______________________________
Essay
Please attach an essay (maximum of 200 words) explaining your reasons for pursuing your chosen
career.
Please include with this application, a sealed letter of
recommendation from a teacher.
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