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Lilly Endowment
Community Scholarship
Application
2015 Cohort
The Community Foundation of Greater Lafayette
www.cfglaf.org
Lilly Endowment Community Scholarship
The Lilly Endowment Community Scholarship Program is designed to raise the level of educational attainment in
Indiana and to leverage further the ability of Indiana’s community foundations to improve the quality of life of the
state’s residents. The Endowment hopes that this program will encourage many of Indiana’s most talented
students to attend one of Indiana’s fine higher education institutions and after graduation consider pursuing
occupations in Indiana.
Scholarships pay for full academic tuition and required fees plus an annual $900 allocation for books and
equipment for four years at any accredited Indiana college or university selected by the recipient. The
scholarships are sponsored by Lilly Endowment Inc. and administered by community foundations throughout
Indiana. The Community Foundation of Greater Lafayette is administering three scholarships in Tippecanoe
County for the 2015 awards.
The Community Foundation of Greater Lafayette
The Community Foundation of Greater Lafayette has been serving the Greater Lafayette area since 1970. Our
mission is to inspire, nurture, and practice philanthropy, stewardship, and leadership in the communities we serve.
Eligibility
Applicants must:
 Have graduated from an accredited Indiana high school in June 2015
 Receive their diploma no later than June 30, 2015
 Have been accepted to pursue a full-time baccalaureate course of study at an accredited public or private
nonprofit college or university in Indiana
 Be an Indiana resident
 Live or attend school in Tippecanoe County
 Have a 2.75+ GPA on a 4.0 scale
 Have a SAT Critical Reading, Essay, and Mathematics score of 1200 or higher OR an ACT composite
score of 16 or higher
The Community Foundation of Greater Lafayette board members, officers, employees, and selection committee
members will not be allowed to participate in any aspect of the nomination process if they have relatives applying
for the Lilly Endowment Community Scholarship.
Criteria for Selection
Selection considerations include:
 community and school activities
 evidence of leadership
 recommendations
 essay
 demonstration of unique/unusual circumstances
 financial need
 grade point average and difficulty of high school courses taken
 finalist interview
Progress Criteria
To remain eligible for scholarship payments, the recipient must submit grade reports to The Community
Foundation of Greater Lafayette, maintain good standing at the college or university, be law-abiding, and
maintain high standards of conduct consistent with the student code of conduct of the college or university
attended. Students will also be required to submit reports of expenditures for books and equipment and a yearly
letter keeping The Community Foundation of Greater Lafayette informed of their progress.
Deadline: noon, January 8, 2015
All materials must be in our office (not just in the mail) by the deadline. Incomplete or late applications will
not be considered; no exceptions are made. Responsibility for ensuring the application is complete and
received on time rests solely with the applicant.
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Application Instructions
Read and follow all instructions carefully. Failure to follow instructions may eliminate your
application from consideration.
 You must fill out your own application and write the essay in your own words. It's acceptable to ask
for proofreading and other help but all work must be yours.
 Include all requested materials (and only the requested materials) and fill out the application
completely and accurately. Incomplete or unsigned applications will not be considered.
 Thorough, precise and legible information on the application form will enhance our ability to consider
your application. Read the entire application completely before formulating your responses.
 Use the application form and the space provided only. Do not include attachments except as
requested.
 All pages of the application should be single-sided only. Do not use the back of pages to submit
information; it will not be considered as part of your application unless our office has instructed you
to put information on the back of a page.
 Please do not tape, staple, glue, or otherwise fasten any part of or anything to your application.
 Completed application should not be folded.
 All materials, including references, must be received by the deadline or the application will not be
considered. It is the applicant’s responsibility to ensure that references have been received.
 Please keep a copy of the application. We cannot provide copies of any application materials,
including references, once submitted.
 Financial Information Instructions:
1.
2.
3.
4.
5.
6.
7.
8.
Log into www.educationquest.org.
On the home page locate “Resources” on the right hand side
Click on the “College Funding Estimator”
Then on the next page click College Funding Estimator “Launch”
Fill out the college funding estimator completely.
Once completed, hit “Next” at the bottom of the page.
The Expected Parent Contribution and Expected Student Contribution will be
displayed.
Enter these numbers at the bottom of page 6.
Application Submission
Use this checklist. Your complete application should include:
application form (pages 4, 5, & 6)
financial information (page 6)
high school transcript (be sure to include most current grades)
senior year class listing, fall and spring semesters
essay (one page only and a font no smaller than 10)
three letters of recommendation (no more than one page each - pages 7, 8, & 9)
Notification of awards will be made in early April 2015.
Hand-deliver or mail to:
LECS
The Community Foundation of Greater Lafayette
1114 East State Street
Lafayette, IN 47905-1219
Business Hours
8:30 am – 4:30 pm, Monday - Friday
Questions may be directed to 765.742.9078 or [email protected].
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Lilly Endowment Community Scholarship
Please read and follow all instructions carefully. Incomplete applications will NOT be considered.
1. Applicant Information Fill out completely. Remember last 4 digits of your Social Security # at bottom of page.
Name: ________________________________________________________________________
Permanent address (street, city, state, zip): ___________________________________________________________
__________________________________________________________________________________________
Phone: ___________________________________
Cell Phone: ___________________________________
E-mail address: _____________________________________________________________________________
Date of birth: _____________ Are you an Indiana resident? _____ County of residence: __________________
2. Family Information
Full name of father/guardian:___________________________________________________________________
Address: ___________________________________________________________________________________
Full name of mother/guardian: __________________________________________________________________
Address: ___________________________________________________________________________________
3. Transcript
Please include an original of your high school transcript through 7th semester, if available.
DEADLINE: noon, January 8, 2015
Certification
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Please read carefully, sign, and date the following:
If I receive this scholarship, it is my intent to pursue four years of undergraduate study on a full-time basis leading to a baccalaureate degree at
an Indiana college or university.
I understand that the total maximum amount of my scholarship is calculated on the basis of my chosen college or university's tuition and
required fees beginning with the 2015-2016 school year.
To assist with the processing of my scholarship payments each semester or quarter and to avoid late fees, I will forward immediately to The
Community Foundation of Greater Lafayette all invoices received for tuition and any eligible fees that may be covered by my scholarship.
I will account for the amount of the special allocation spent for required books and required equipment with official receipts and other
documentation. I will return to Independent Colleges of Indiana any amount of the special allocation remaining at the end of each school year.
I agree to notify Independent Colleges of Indiana of any scholarship awards I may receive for tuition or required fees from a source other than
the Lilly Endowment Community Scholarship.
I will keep The Community Foundation of Greater Lafayette apprised annually by June 1st of my enrollment and academic status during
college, by completing and returning any surveys or forms as may be provided by the community foundation.
Upon graduation, I will keep The Community Foundation of Greater Lafayette apprised annually by June 1st of my education and/or
employment status for at least ten years after graduation, by completing and returning an alumni survey or other forms as may be provided by
the community foundation.
If selected, I will notify The Community Foundation of Greater Lafayette no later than April 29, 2015, which college or university I will
attend.
I hereby affirm that the information provided on this form is accurate and complete to the best of my knowledge, that I have completed the
application and written the essay myself, and that I understand falsification of information will result in the withdrawal of my application from
the selection process or termination of my scholarship.
I also affirm that I have not applied for a Lilly Endowment Community Scholarship through any other source.
I give permission for the release of my transcripts to the scholarship selection committee.
__________________________________________________________
Signature of applicant
_____________________________________________
Date
Last 4 digits of Applicant's Social Security Number: __________
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4. Academic Information
Fill out completely
High School: _______________________________________________Graduation Date: _________________
Cumulative Grade Point Average (include current semester grades): _____________ (on a scale of ____________)
Counselor: ___________________________________ Phone (include extension #): _____________________
SAT Scores: ________ (critical reading) _________ (math ) ________ (writing) OR ACT Scores: _______ (combined)
5. College Application Status Please list all colleges and universities to which you have applied. Also
indicate admission status (admitted, pending, denied admittance).
6. Major
What is your anticipated major and profession?
7. Other Awards
Have you made a commitment to any branch of the military that will pay for college tuition?
_________
Please list all other scholarships or awards for which you have submitted an application or are considering applying for.
Include the amount, the status (will submit application, received, denied, pending), and if a multi-year award:
8. Essay
Using one page only, please tell us your aspirations and how you hope to reach them. Clearly link your
answers to the objectives of this scholarship. What is your vision for the future? How will the Lilly Scholarship assist you?
Include unique circumstances or special achievements. Give us any personal information about yourself that you believe
would help in our selection of a scholarship recipient. Be sure your essay reflects your thoughts, is well thought-out, and
clearly written. You must write your own essay or else the application will be disqualified. Do not use a font smaller than
size 10. Please use only standard white 8 1/2 by 11 inch paper. No card stock, colored or designed paper.
Please note
The last 4 digits of your Social Security Number MUST be in the bottom right corner of the essay page. Do not
include your name on the essay page.
9. Recommendations
Please list the names of the three people who are writing your reference letters and also
their relationship to you. Be sure that at least one of those people is associated with your school. See pages 7-9 for additional
instruction about reference letters.
1. __________________________________________________________________________________________________
2. __________________________________________________________________________________________________
3. __________________________________________________________________________________________________
Applicant’s First Name: ____________________
Last 4 Digits of Applicant's Social Security Number: ____________________
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10. School Activities
(Clubs, student government, National Honor Society, sports, music, drama,
community service, etc.) Using only the space below, list the most important activities you have
participated in the last four years. Please list in order of importance to you (most important first).
Activity
Leadership positions, awards,
recognition, etc.
Dates
11. Community Activities
(NOT school-related - Volunteer work, Scouts, religious, sports, 4-H,
music, drama, etc.) Using only the space below, list the most important activities you have participated
in the last four years. Please list in order of importance to you (most important first).
Activity
Dates
Leadership positions, awards,
recognition, etc.
School-related
activity?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Using only the space below, please list paid work experience in
chronological order, beginning with your most recent position.
12. Work Experience
Employer
Nature of work
Dates
Hours/wk
School-related
activity?
Yes
No
Yes
No
Yes
No
Yes
No
13. Financial Information Please include your family contribution in the space below. See page 3
of application instructions.
Expected Parent Contribution: $___________ Expected Student Contribution: $_____________
Applicant’s First Name: ____________________
Last 4 Digits of Applicant's Social Security Number: ____________________
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Lilly Endowment Community Scholarship
Recommendation Instructions
To the Applicant
Your application must include three (and only three) letters of recommendation. The recommendation is to be
completed by a teacher, minister, coach, employer, etc. Do not submit recommendation letters written by family
members. Please give this sheet to the recommender. Completed recommendations must be received at The
Community Foundation of Greater Lafayette by the deadline for your application to be considered. It is your
responsibility to ensure that the recommendation is received in our office by the deadline. You may want to give
the recommender an addressed, stamped envelope. The recommendation letter may also be e-mailed to
[email protected] but MUST be sent as an attachment that includes the recommender’s signature.
All recommendations are confidential. We do not release copies to applicants.
To the Recommender
Please read and follow all instructions carefully.
1.
Please do not use the applicant's last name when writing your recommendation; we use a blind
application process.
2.
Limit your recommendation to one page. Anything longer than one page is not considered. Please type
your letter. Please do not use a font smaller than 10.
3.
Use standard letter-weight paper (no heavy paper or cardstock). Do not attach anything to the letter.
4.
E-mail recommendations are accepted, but MUST be sent as an attachment that includes your
signature. Type “LECS” in the memo field of the e-mail.
5.
The recommendation should include the following:
your full name (printed)
your signature and contact number
your relationship to applicant
the date
6.
The last 4 digits of the applicant’s Social Security Number must be in the bottom right corner of
your letter so the recommendation can be matched to the student's application.
7.
Recommendation: Please discuss the individual's character, leadership, personal initiative, work habits,
and any other attributes you think qualifies the individual for the Lilly Endowment Community
Scholarship. Include any unique factors that make this applicant especially worthy of this scholarship.
If you have any questions, please contact The Community Foundation of Greater Lafayette!
(765.742.9078 or [email protected])
Hand-deliver, mail, or e-mail to:
LECS
The Community Foundation of Greater Lafayette
1114 East State Street
Lafayette, IN 47905-1219
[email protected]
Business Hours
8:30 am – 4:30 pm, Monday – Friday
DEADLINE: noon, January 8, 2015
Late recommendations will not be included and will disqualify the applicant from scholarship consideration.
Applicant’s First Name: ____________________
Last 4 Digits of Applicant's Social Security Number: ____________________
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Lilly Endowment Community Scholarship
Recommendation Instructions
To the Applicant
Your application must include three (and only three) letters of recommendation. The recommendation is to be
completed by a teacher, minister, coach, employer, etc. Do not submit recommendation letters written by family
members. Please give this sheet to the recommender. Completed recommendations must be received at The
Community Foundation of Greater Lafayette by the deadline for your application to be considered. It is your
responsibility to ensure that the recommendation is received in our office by the deadline. You may want to give
the recommender an addressed, stamped envelope. The recommendation may also be e-mailed to
[email protected] but MUST be sent as an attachment that includes the recommender’s signature.
All recommendations are confidential. We do not release copies to applicants.
To the Recommender
Please read and follow all instructions carefully.
1.
Please do not use the applicant's last name when writing your recommendation; we use a blind
application process.
2.
Limit your recommendation to one page. Anything longer than one page is not considered. Please type
your letter. Please do not use a font smaller than 10.
3.
Use standard letter-weight paper (no heavy paper or cardstock). Do not attach anything to the letter.
4.
E-mail recommendations are accepted, but MUST be sent as an attachment that includes your
signature. Type “LECS” in the memo field of the e-mail.
5.
The recommendation should include the following:
your full name (printed)
your signature and contact number
your relationship to applicant
the date
6.
The last 4 digits of the applicant’s Social Security Number must be in the bottom right corner of
your letter so the recommendation can be matched to the student's application.
7.
Recommendation: Please discuss the individual's character, leadership, personal initiative, work habits,
and any other attributes you think qualifies the individual for the Lilly Endowment Community
Scholarship. Include any unique factors that make this applicant especially worthy of this scholarship.
If you have any questions, please contact The Community Foundation of Greater Lafayette!
(765.742.9078 or [email protected])
Hand-deliver, mail, or e-mail to:
LECS
The Community Foundation of Greater Lafayette
1114 East State Street
Lafayette, IN 47905-1219
[email protected]
Business Hours
8:30 am – 4:30 pm, Monday - Friday
DEADLINE: noon, January 8, 2015
Late recommendations will not be included and will disqualify the applicant from scholarship consideration.
Applicant’s First Name: ____________________
Last 4 Digits of Applicant's Social Security Number: ____________________
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Lilly Endowment Community Scholarship
Recommendation Instructions
To the Applicant
Your application must include three (and only three) letters of recommendation. The recommendation is to be
completed by a teacher, minister, coach, employer, etc. Do not submit recommendation letters written by family
members. Please give this sheet to the recommender. Completed recommendations must be received at The
Community Foundation of Greater Lafayette by the deadline for your application to be considered. It is your
responsibility to ensure that the recommendation is received in our office by the deadline. You may want to give
the recommender an addressed, stamped envelope. The recommendation may also be e-mailed to
[email protected] but MUST be sent as an attachment that includes the recommender’s signature.
All recommendations are confidential. We do not release copies to applicants.
To the Recommender
Please read and follow all instructions carefully.
1.
Please do not use the applicant's last name when writing your recommendation; we use a blind
application process.
2.
Limit your recommendation to one page. Anything longer than one page is not considered. Please type
your letter. Please do not use a font smaller than 10.
3.
Use standard letter-weight paper (no heavy paper or cardstock). Do not attach anything to the letter.
4.
E-mail recommendations are accepted, but MUST be sent as an attachment that includes your
signature. Type “LECS” in the memo field of the e-mail.
5.
The recommendation should include the following:
your full name (printed)
your signature and contact number
your relationship to applicant
the date
6.
The last 4 digits of the applicant’s Social Security Number must be in the bottom right corner of
your letter so the recommendation can be matched to the student's application.
7.
Recommendation: Please discuss the individual's character, leadership, personal initiative, work habits,
and any other attributes you think qualifies the individual for the Lilly Endowment Community
Scholarship. Include any unique factors that make this applicant especially worthy of this scholarship.
If you have any questions, please contact The Community Foundation of Greater Lafayette!
(765.742.9078 or [email protected])
Hand-deliver, mail, or e-mail to:
LECS
The Community Foundation of Greater Lafayette
1114 East State Street
Lafayette, IN 47905-1219
[email protected]
Business Hours
8:30 am – 4:30 pm, Monday - Friday
DEADLINE: noon, January 8, 2015
Late recommendations will not be included and will disqualify the applicant from scholarship consideration.
Applicant’s First Name: ____________________
Last 4 Digits of Applicant's Social Security Number: ____________________
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