Columbia (Mo.) African American Association Memorial Scholarship

CAAA MEMORIAL SCHOLARSHIP APPLICATION

Section A - General Information

Section A - General Information

Applicant’s Name:___________________________________________________

          Last                                       First                                                    MI

Permanent Address:             _________________________________________________

Number and Street Phone

___________________________________________________________________

City State Zip

Date of Birth ____________________________________________________________________

Month Day Year

Gender:   Male______ Female______

Name of Parent or Guardian:  

_______________________________________________________________________

Parent or Guardian’s Address: _

_______________________________________________________________________

Name and phone number of guidance counselor or favorite teacher:

________________________________________________________________________

Section B - Education Program Information

I will complete high school by June 2010 and enroll in an accredited college or university by Fall 2010:  Yes ___   No___

What high school are you currently enrolled?

What is your current class ranking?

What is your present grade point average (GPA)?   

What college or university are you planning to attend (include address)?

Have you been accepted by the college or university indicated above? Yes ___ No___

If you have not been accepted, to what other colleges or universities have you applied?

Section C - Student Profile Information

List academic accomplishments (example: honor roll, dean’s list, Who’s Who or any other additional honors, awards/scholarships received). 

List community service activities (example: Church, Big Brothers & Sisters, DARE, Adopt-a-Highway Clean-up, Boys & Girls Club etc…) you have participated in.

List extracurricular school activities and leadership involvement (athletics, student body president, membership in clubs/organizations, ROTC, cheerleading, band, basketball team captain, drama club, booster club etc…) include offices held.

What are your career goals?

In what ways do you think your career goals will enable you to contribute to your community?

Identify the biggest incident/challenge in their life and how they persevered and showed resiliency to overcome.

Section D – Student Essay Information

Applicants are required to submit a TYPE-WRITTEN essay (minimum 600 words, maximum 1500 words) on the following topic:

Black-on-black crime has reached epidemic proportions. As a black youth, what would you prescribe to combat this epidemic in Columbia, Missouri and the rest of America?

Section E – Attach Official Academic Transcript

Section F – Attach Recommendation Letters (2)

For questions or more information, contact:

Melvin Clayborne

Co-Chairman,    

CAAA Memorial Scholarship Fund     

Hickman High School Alumni,

"Class of 1980"

(315) 408-5604 ©

melvin@columbiaafricanamericanassociation.com

Keener A. Tippin II

Treasurer,

CAAA Memorial Scholarship Fund

Hickman High School Alumni,

"Class of 1979"

(573) 289-6536

keener@columbiaafricanamericanassociation.com