The Richard A. Ash Scholarship Fund APPLICATION DEADLINE: April 15, 2013 Richard Ash was a prominent Center City attorney. He believed in preserving the values of our constitution and those traditions that sprung from our better nature. Mr. Ash was kind to his friends and generous to the less fortunate. He was active in and passionate about city affairs, driven by his love for Philadelphia. Mr. Ash frequently challenged long-held notions that excluded minorities and women. He dedicated much of his legal career to championing the underdog and to various causes which included the advancement of young people from disadvantaged backgrounds. Mr. Ash left a generous bequest establishing this fund which provides scholarships to Philadelphians who could not otherwise afford to go to college.
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SELECTION CRITERIA Applicant must be a Philadelphia resident who is a graduating high school senior or adult student interested in seeking a college education and who demonstrates financial need. This scholarship is for Undergraduate Study ONLY.
AWARD AMOUNT Scholarship award amounts will generally range from $1,000 per year up to 90% of the full educational cost. Scholarship awards may be applied to primarily tuition, books and fees.
APPLICATION SUBMISSION INSTRUCTIONS INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please answer all questions, attach requested documents and make sure the application is signed by applicant and/or parent/guardian. If a question does not apply to you, please mark “N/A”. A Completed Application Includes: (Please check the boxes to indicate the attachments you have submitted. If an attachment is not applicable to you, please mark “N/A” next to the check box) Attachment “A”
Copy of your high school transcript (if applicable).
Attachment “B”
Copy of your post high school transcript (if applicable).
Attachment “C”
Copy of your acceptance letter received from the college/university you plan to attend.
Attachment “D”
Copy of your financial award letter from the college/university you plan to attend (if applicable).
Attachment “E”
Copy of your final SAR or FAFSA Report returned from the U. S. Department of Education.
Attachment “F”
Copy of your college/university’s estimated cost of attendance. (This information can be obtained from the college’s financial aid office, college brochure, or college website).
Attachment “G”
Essays: 1) Aspiration and Goals Essay and 2) Additional information you would like to us to know about you including any “unusual circumstances” that should be considered.
Attachment “H”
Recommendation Form (provided with the application) must be completed and placed in a sealed envelope by the person who completed the form and submitted with this application. Please mail your application and all required attachments in ONE envelope to: The Philadelphia Foundation Attention: Richard A. Ash Scholarship 1234 Market Street, Suite 1800 Philadelphia, PA 19107
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RICHARD A. ASH SCHOLARSHIP APPLICATION APPLICANT INFORMATION
Please print or type
Name _____________________________________________________________________________________________________ Last
First
Middle
Permanent Address ___________________________________________________________________________________________________________ Street
___________________________________________________________________________________________________________ City
County
Telephone (_____) ____________________________
State
Zip
Email: __________________________________________________ Please print clearly
Date of birth _________________________________
FAMILY INFORMATION
Gender: ______ Social Security:
XXX – XX – __ __ __ __
Please circle relationship
Father/stepfather/guardian__________________________________________________________________________________ Address ___________________________________________________________________________________________________ Street
City
State
Zip
Mother/stepmother/guardian________________________________________________________________________________ Address___________________________________________________________________________________________________ Street
City
State
Number of siblings financially dependent on parent(s)/guardian_________ If you are an independent student: Marital Status: Single Married
Divorced
Zip
Total number of family members ___________
Number of dependents: _____
Annual Family Income: (Adjusted Gross Income) Under $25,000 $25,000 - $35,000 $45,000 - $55,000 $55,000 - $75,000
$35,000- $45,000 Over $75,000
HIGH SCHOOL INFORMATION Please attach:
A copy of your official transcript if applicable (Attachment “A”)
High school attended ________________________________________________________________________________________ Year of graduation ____________________ SAT Scores: ____________ Class Rank_____________
POST SECONDARY EDUCATION INFORMATION Please attach:
A copy of your acceptance letter received from the college/university (Attachment “B”) A copy of your post-high school transcript if applicable (Attachment “C”)
Institution for which aid is requested__________________________________________________________________________ ___________________________________________________________________________________________________________ Street
___________________________________________________________________________________________________________ City
County
State
Zip
Intended field of study:_______________________________ Degree Sought_________________________________________ Richard A. Ash Scholarship
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If you are presently a college student, please give your GPA: _______
Expected graduation date: _________________
FINANCIAL AID INFORMATION Please attach:
Financial award letter from your college/university if applicable (Attachment “D”) Copy of your final SAR or FAFSA Report returned from the U. S. Department of Education (Attachment “E”)
Cost of Education per year: Please attach:
Copy of your college/university’s estimated cost of attendance (Attachment “F”)
EXPENSES
Amount
Tuition and Fees
Total
$________________
Room and Board
$________________
Books and Supplies
$________________
Transportation
$ ________________
TOTAL EXPENSES
$______________ (A)
INCOME
NAME OF GRANT OR SCHOLARSHIP
Federal, State & Other Awards _____________________________ (List loans and work study in Loan section below) _____________________________
$_______________
_____________________________
$_______________
_____________________________
$_______________
_____________________________
$_______________
_____________________________
$_______________ applied received
_____________________________
$_______________ applied received
_____________________________
$_______________ applied received
_____________________________
$_______________ applied received
_____________________________
$_______________ applied received
College Grants & Scholarships (List loans and work study in (Loan section below)
$_______________
TOTAL GRANTS & SCHOLARSHIPS
$_______________(B)
Estimated Family Contribution from Student Air Report (SAR)
$_______________(C)
TOTAL INCOME (Item B plus Item C)
$_______________(D)
FINANICAL NEED (Item A minus Item D)
$_______________(E)
LOANS AND EMPLOYMENT
NAME OF SOURCE _____________________________
$_____________________
_____________________________
$_____________________
____________________________
$_____________________
TOTAL LOANS & EMPLOYMENT
$_____________________
Financial information is confidential for review only by the members of the Advisory Committee and The Philadelphia Foundation. Richard A. Ash Scholarship Page 3 of 6
ASPIRATIONS AND GOALS (Attachment “G”) 1.
Please attach an essay describing your personal ambitions and educational and career goals. This essay should be no longer than 2 typewritten double-spaced pages and must include information that will answer each of the following questions:
What are your short and long term career goals and what do you feel has inspired or contributed to the development of these goals? How do you plan to apply career goals to benefit society? Beyond your career goals what is your personal life’s mission? Please state your favorite quote and why that quote is important to you.
2. Please attach a statement describing any additional information you would like us to know about you including any unusual personal, financial, or family circumstances that warrant any special attention by the selection committee. Your statement should be no longer than 1 double spaced page.
CERTIFICATION AND SIGNATURES I, (we) certify that the information on this form is true and compete to the best of my (our) knowledge. If asked by any authorized official of The Philadelphia Foundation, I (we) agree to give the documentation for information given on this form. I (we) realize that failure to comply with a request for additional information may prevent the applicant from receiving any aid. I also grant The Philadelphia Foundation permission to use my photograph and/or selected quotes on their website and in future publications. ____________________________________________________________________________________________ Applicant signature Date ____________________________________________________________________________________________ Parent signature Date Send completed application and all required attachments together in ONE envelope to:
The Philadelphia Foundation Richard A. Ash Scholarship 1234 Market Street, Suite 1800 Philadelphia, PA 19107 Please E-mail any questions to scholarships@philafound.org APPLICATIONS MUST BE RECEIVED BY THE FOUNDATION BY APRIL LATE APPLICATIONS WILL NOT BE CONSIDERED.
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15, 2013.
Attachment H
Richard A. Ash Scholarship Scholarship Recommendation Form
Recommendation form must be completed and placed in a sealed envelope by the person who completed the form. The sealed enveloped should be submitted along with the application. Recommendations must be someone not related to you. (Ex. Teacher, Counselor, Spiritual Leader, Employer…) Please contact Sylvia Spivey at (215) 863-8121 if you have any questions. Completed applications are due by to The Philadelphia Foundation by April 15, 2013
Applicant’s Name: __________________________________________ Date: ________________ Print Applicant’s Signature ______________________________________________________________ Note: Signature grants permission to send information
Academic Evaluation
Check in the appropriate column your estimate of each trait listed. Outstanding
Good
Average
Below Average
No Basis for Judgment
Academic Ability Academic Performance Academic Motivation Academic Growth Potential
Personal Evaluation
Check in the appropriate column your estimate of each trait listed. Outstanding
Good
Average
Below Average
Originality Energy Independence Leadership Maturity Initiative Reaction to set-backs Trustworthy Sensitivity to others
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No Basis For Judgment
In what context and for how long have you known the applicant?
_______________________________________________________________ _______________________________________________________________ _______________________________________________________________ Describe this applicant.
_______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________
How do you think this applicant will perform in college?
_______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________
Name: __________________________________ Title: __________________________ Signature: ______________________________
Date: __________________________
Phone No.:______________________________
Application Due by April 15, 2013
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