2015 Scholarship Programs The Northwest Hope Foundation is pleased to announce that this year there will be up to thirteen (13) Scholarship Awards of up to $2,000.00 each. These awards must be used at an accredited college or university, technical or vocational school, or junior or community college for any courses of study. The Scholarship Award is to help pay for tuition, fees, books, educational expenses, and educational materials for the academic year 2015-2016. If you are interested in pursuing this path, please initial here. _________ In addition to the awards above, The L Walt Derry Scholarship is for those motivated students seeking a career in the labor movement advancing worker rights and fighting for working families. There will be one scholarship of $2,500.00 awarded this year. The Scholarship is to offset costs in traditional college and trade school programs including but not limited to: Human Resources; Labor Relations; Arbitration; Collective Bargaining; Investigation; Counseling; and Public Relations. If you are interested in pursuing this path, please initial here. _________ If you want to apply for both, initial here. _________ For more information 1-800-452-UFCW. you are encouraged to contact your Union Representative at You may also contact us at 1 (800) 452-8329 ext. 6354 or send questions to [email protected]. Eligibility Requirements: Any full active member of UFCW Local 555 in good standing for at least one (1) year prior to the application deadline (May 8, 2015) is eligible to apply. A member may also sponsor their child, grandchild, or spouse. A scholarship application, official high school and/or official college transcripts, an essay of up to 500 words, a picture (preferred but optional—to be used in publications), and three (3) letters of recommendation must be received by May 8, 2015 and sent to the Northwest Hope Foundation. Anything submitted in excess of the above will not be considered. All materials will be judged by the Scholarship Committee. Only the winners will be notified, and their pictures may be published in the UFCW Local 555 Newsletter. 2015 Scholarship Application Page 1 of 6 2015 SCHOLARSHIP APPLICATION Deadline is May 8, 2015 Complete Sections I through V: Please type or print neatly. Include additional pages, if necessary. To be eligible to compete for a scholarship, a signed, completed application, your most recent official high school and/or official college grade transcripts, three letters of recommendation, and your personal essay must be received no later than May 8, 2015. SECTION I – APPLICANT PROFILE Applicant Data: ______________________ ______________________ ______________________ Last Name First Name Middle Name ______________________________________________________________________ Street Address ______________________ ______________________ ______________________ City State Zip Code ( _______ ) ____________ - ____________ ______ / ______ / ______ Telephone Number Date of Birth ____________ -- __________ -- ____________ Social Security Number UFCW 555 Member: □ Yes □ No ______________________ How long? ______________________________________________ ______________________ Employer Name / Location Employer Department 2015 Scholarship Application Page 2 of 6 SECTION II – SPONSOR PROFILE Sponsor Data: (If applicant is not a member) ______________________ ______________________ ______________________ Sponsor’s Last Name First Name Middle Name ____________ -- __________ -- ____________ ______________________ Social Security Number Age UFCW 555 Member: □ Yes □ No ______________________ Relation to Applicant ______________________________________________ ______________________ Employer Name / Location Employer Department ______________________________________________ ______________________ Job Title Years on the Job SECTION III – EDUCATIONAL PROFILE Currently I am enrolled as: □ High School Senior □ College □ Not Enrolled _________________________________________________________________________________________ High School ____________________________________________ City / State ___________________________________________ Class of (Year) □ Public □ Parochial □ Independent □ Military □ General □ Honors □ Advanced Placement □ Other: High School Type: High School: _____________________________ (specify) _________________________________________________________________________________________ College Name ____________________________________________ ___________________________________________ City / State Class of (Year) College Type: □ Public □ Parochial □ Independent □ Military College Program: □ General □ Honors □ Advanced Placement □ Other: __________________________ (specify) Colleges / Universities To Which You Attend or Plan to Apply: ____________________________________ Name ____________________________________ City / State ____________________________________ Name ____________________________________ City / State 2015 Scholarship Application Page 3 of 6 ____________________________________ Name ____________________________________ City / State Future Career Plan: ____________________________________ Field High School or College Activities List your activities, such as clubs, academic or athletic teams. [Sample: Yearbook, Spanish Club] ____________________________________ Job Title Role / Office List position or leadership role held, if any. [Editor, Member] High School or College Awards List the full name of academic or school-related awards and year received. [Sample: National Merit Scholarship] Years List years of membership. [12th, 11th, 10th] Year Honor Roll / Society List names and membership years. [2006] [Honor Roll 12th, 11th, 10th] 2015 Scholarship Application Page 4 of 6 SECTION IV – WORK EXPERIENCE List Jobs Held During High School or College Years or Jobs Held Currently Employer Name Job Title Dates of Employment From - To Average Hours Worked Per Week SECTION V – COMMUNITY ACTIVITIES List Community Service Activities Performed During High School or College Years or Performed Currently (church work, hospital volunteer, community projects, etc.) Organization Name Activity Years of Participation After finishing school, how will this scholarship enable you to serve your community? __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 2015 Scholarship Application Page 5 of 6 SECTION VI – PERSONAL ESSAY up to 500 words Provide additional information about your goals, hobbies, philosophy, motivations, family, or any details that would be of value to application evaluators. Include additional pages, if necessary. __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 2015 Scholarship Application Page 6 of 6 I have read and completed this application, provided my official high school and/or official college grade transcripts, three letters of recommendation, and my personal essay. I certify that the information is correct and is submitted with my approval, and I authorize the use of this confidential information by the Northwest Hope Foundation. ______________________________________________ Signature __________________________ Date Deadline: May 8, 2015 (Received) Mailing address: Scholarship Committee Northwest Hope Foundation P.O. Box 23555 Tigard, OR 97281-3555 Questions: (503) 598-6354 or 1-800-452-UFCW, ext. 6354 Checklist*: □ Scholarship Application □ Official Transcripts □ Essay up to 500 words □ Three (3) letters of recommendation □ Picture (preferred but optional – for use in publications) * These items will not be returned.
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