Edwin Budge Mead Scholarship Application To be eligible for the FHW Foundation Edwin Budge Mead Scholarship students must meet the following criteria:  Graduating senior  Lake County public or private High School located in Florida Hospital Waterman’s primary service area  3.0 GPA  Currently accepted into a college, university or technical school Please complete the application and attach the following:  Three (3) Recommendation letters, one from each of the following (Teacher, School Administrator and Community Member)  Record of Community Service hours (minimum of 100)  Personal essay to include why you have chosen this career path, why you are requesting scholarship funds and any personal information you wish to share regarding your scholarship request. (200 word minimum)  High School Transcripts (Official – provided through your respective Guidance Office) Return your completed application and required attachments to your guidance counselor by April 10, 2015. Incomplete applications will be disqualified. Section 1: Personal Information Last Name: Address: First Name: Phone Number: Email: Section 2: Education Information Cell Number: Date of Birth: High School Currently Attending: Class Rank: Weighted GPA: ACT Composite: List extra-curricular activities, such as clubs and sports: Graduation Date: Un-weighted GPA: SAT Composite: List honors classes and awards: Section 3: College, University or Technical School Information To what school have you been accepted: Degree or certification you are pursuing: Address: Program contact person: Length of program: Date expected to begin: Phone number: Tuition amount: 1 Additional Information:  Schools located in Florida Hospital Waterman’s Primary Service Area include: Adventure Christian Academy, Eustis High School, Liberty Christian Preparatory School, Mount Dora Christian Home & Bible School, Mount Dora High School, Tavares High School and Umatilla High School  Scholarship applicants meeting the criteria and fulfilling the requirements will be considered for scholarship awards up to $2,000.  Students receiving Budge Mead Scholarship funds for a degree or certification in health care are eligible to apply (following acceptance into program) for matching funds from the Florida Hospital Waterman Foundation. Matching funds do not cover prerequisites.  Students and Guidance Offices will be notified of scholarship awards in May of 2015.  Scholarship funds will be released to each recipient’s respective school in June 2015 and will cover tuition, books and lab fees.  Any unused funds remaining in the student’s school account will be returned to the Florida Hospital Waterman Foundation one year (12 months) from distribution to school. Student (please print) Student Signature Date For Completion by the Guidance Office: Please confirm you have reviewed the scholarship application. Date Returned to Guidance Office Guidance Counselor (please print) Phone number Signature Date 2