2015 Mary L. Broussard Scholarship The friends and family of Mary

2015 Mary L. Broussard Scholarship
The friends and family of Mary L. Broussard are proud to offer two scholarships to high achieving and deserving
high school seniors from the Bryan/College Station communities in 2015 to honor Mary’s service to our
communities. The scholarship will be in the amount of $1,000 for one year, and students must have a minimum
grade point average of 3.0 to be eligible. The competition is open to all public high school students in the Bryan
and College Station communities. The scholarship will recognize a student who combines academic achievement
with strong and meaningful community service or an outstanding record in extra-curricular activities that benefit
the College Station/Bryan communities.
Applicants are required to provide a completed application, a recent photograph (for publicity purposes), one
letter of support, an official high school transcript, and verification of their grade point average and class rank.
Scholarship recipients must offer proof of enrollment in an accredited college or university by June 2015. The
Mary L. Broussard scholarship will be awarded at the annual Freedom Fund Banquet of the Brazos County NAACP
on Saturday, June 6, 2015, at the College Station Hilton.
All application materials should be returned to your high school counselor by Friday, May 6. Additional questions
may be directed to Mr. Albert S. Broussard at (979) 696-6529 or Mary Broussard at (979) 571-0501.
2015 MARY L. BROUSSARD
SCHOLARSHIP APPLICATION
INSTRUCTIONS:
Please complete this form and return to Mrs. Chrissy Hester, whose address is located at the bottom of this application, no later
than May 6, 2015. To be considered you must submit all required information by this date. Incomplete applications will be
disqualified.
BIOGRAPHICAL INFORMATION
Name: (First) _______________________ (Middle) _____________________ (Last) _______________________
Address: _____________________________________________________________________________________
City ________________________________ State _______________________________ Zip ________________
Telephone: ___________________________________
Name of parent/guardian: _______________________________________________________________________
Telephone: ___________________________________
EDUCATIONAL BACKGROUND
High School: __________________________________________________________________________________
High School Graduation Date: _____________________________________________________________
Grade Point Average: ____________
Rank: ___________
SAT/ACT Scores: __________________
College you plan to attend: ______________________________________________________________________
Have you been accepted?
Yes ____________ No ___________
Major Field of Study: __________________________________________________________________________
HIGH SCHOOL CURRICULAR ACTIVITIES/AWARDS/ HONORS:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
PLEASE LIST OTHER SCHOLARSHIPS YOU HAVE RECEIVED AND THE AMOUNTS:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
EXTRACURRICULAR AND COMMUNITY INVOLVEMENT:
(Include community organizations or projects, activities or events that you have been an active participant. Include leadership
positions that you hold or have held).
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________
PROVIDE A STATEMENT NOT EXCEEDING ONE PAGE EXPLAINING WHY YOU SHOULD RECEIVE
THIS SCHOLARSHIP: (You may attach an additional page to the completed application)
(You may include plans for continuing your education, academic and career goals, personal circumstances, etc.)
LETTER OF RECOMMENDATION:
(Please submit one letter of recommendation from a teacher, counselor, or community leader with your application. The letter of
recommendation should come from an individual who is personally acquainted with your character, potential, motivation,
academic performance and is willing to provide you with a strong recommendation.)
ADDITIONAL INFORMATION:
Please feel free to provide any additional information that will help us to in our decision making or the importance of
this scholarship in helping you toward reaching your educational goals.
REFERENCES:
Please list at least two References: (You may include teachers, counselors, clergy, organization leaders etc.)
1. Name: _______________________________________________Telephone __________________________
2. Name: _______________________________________________Telephone __________________________
TRANSCRIPT:
Applicants are required to include an official copy of their high school transcript.
COUNSELOR CERTIFICATION:
I ___________________________________________ certify that the GPR, Rank, and SAT/ACT scores are
accurate as listed in the application or the official transcript.
Counselor Name____________________________ ___________________________________________
(Print)
Signature
APPLICANT SIGNATURE: _______________________________________________________________
DATE: ____________________________________
Please turn in the completed application along with other required materials and information to:
Mrs. Chrissy Hester
College Station High School
4002 Victoria Ave., College Station, TX 77845
(979) 694-5800
Additional questions can be directed to Dr. Albert S. Broussard at (979) 696-6529 or
Mary Broussard at (979) 571-0501
APPLICATIONS RECEIVED AFTER MAY 6, 2015 WILL NOT BE ACCEPTED