HSMD Jones Scholarship Application

Dr. Lerroy V. Jones HSMD Student Scholarship Application

Student Name ________________________________________________Phone No. ______________

Address ____________________________________________________________________________

___________________________________________________________________________________

School Name, Address_________________________________________________________________

___________________________________________________________________________________

Anticipated graduation date _________________________________

1. Provide a transcript of your high school courses - request that your high school send such to the HSMD President directly, or attach it in a sealed envelope.

2. List courses you are taking during the Spring Semester of your senior year (the transcript usually does not include courses not yet completed). Indicate those that are Honors, Advanced, Advanced placement, or taken at a college/university.

Senior Spring Semester Courses

_________________________________________________________________________________

3. Describe your extracurricular achievements, awards, and contributions to community. Be specific.

_________________________________________________________________________________

4. Request a letter of recommendation (in a sealed envelope) from a teacher, guidance counselor, or high school Principal and attach it to this application.

5. Write an essay, not longer than one page, on the provided topic and submit it with the application.