APPLICATION for the Kay Sneary Boltz Women in STEM Scholarship

Phone

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Student/Applicant Legal Name(Required)

First Middle Last

Student/Applicant Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Student/Applicant Phone(Required)

Student/Applicant Email(Required)

Please provide an e-mail address that you will continue to use following graduation.

Gender(Required)

Female

Male

I do not wish to disclose

Name of High School(Required)

GPA - unweighted(Required)

Please enter a number from 2.0 to 4.0.

Are you a U.S. citizen?(Required)

Yes

Have you ever had a felony conviction?(Required)

Yes

Please list awards, honors, school clubs (including offices held, if applicable), & extracurricular activities.(Required)

Please separate each item with a comma, and provide dates in parentheses. For example: Student Council (2019-2020), Soccer Team (2021-2022), Soccer Team Captain (2020), Band (2019-2020). If none, please write N/A.

Please provide employment history.(Required)

Please separate each job with a comma, and list dates of employment in parentheses. For example, Lawn care (2019-2020), Office Assistant (2020-2021). If you have no employment history please write N/A.

What are your college plans, including your intended major?(Required)

How will receiving this scholarship affect your college plans?(Required)

Essay #1: List up to 3 accomplishments during your high school years that you are most proud of related to STEM. If listing more than one, one may be outside area of STEM.(Required)

Write 1 to 2 paragraphs about each accomplishment, providing background details, your involvement in any process and the outcome, and any significant things you learned working on the accomplishment. 500 words max.

Essay #2: State what STEM area you expect to focus on, why this is a good fit for you, and your current goals for using that knowledge in your career after college.(Required)

300 words or less.

I acknowledge that:(Required)

I must provide an OFFICIAL TRANSCRIPT to the BCF prior to the application deadline.

Your OFFICIAL TRANSCRIPT should be delivered electronically by your school counselor/administrator or e-transcript service (like Parchment) to scholarship@bartlesvillecf.org. Transcripts may also be mailed by the counselor/administrator or e-transcript service to the Bartlesville Community Foundation office at 321 SE Delaware Ave, Bartlesville, OK 74003. Transcripts should NOT be prepared or printed by the applicant.

I acknowledge that:(Required)

I must have TWO letters of recommendation emailed to the BCF prior to the application deadline.

Letters must be emailed to scholarship@bartlesvillecf.org by the individuals making the recommendation.

Please list the names of the two individuals providing your letters of recommendation.(Required)

The letters should be from unrelated individuals. If you do not provide the names of the individuals writing your letters, we may not be able to pair them with your application properly. Please have the authors e-mail their letters to scholarship@bartlesvillecf.org.

FAFSA Submission Summary(Required)

Accepted file types: pdf, Max. file size: 16 MB.

Please upload a PDF of your FAFSA Submission Summary. It should include ONLY the first page(s), from your name up to and including the Student Aid Index number. (Refer to FAQs for more information.)

I have verified that:(Required)

my attached FAFSA Submission Summary includes my name and my SAI number.

Are you related to any Bartlesville Community Foundation employees, Board members, or Scholarship Committee members?(Required)

Yes

I don't know

If you answered "yes" above, please list the individual's name and the nature of your relationship.

I understand that:(Required)

this submission, and any required submissions by others, is my responsibility.

You may contact the BCF to verify that all correct materials have been received.

Please type your name(Required)

By typing your name, you are signing to acknowledge that all information provided in this application is true and correct to the best of your knowledge and that you, the student, completed the application and any required addendums/essays. You should understand that the intent of the Bartlesville Community Foundation and the Scholarship Committee to collect and maintain this data, specifically your term grades and transcript, is to determine your eligibility for this scholarship. Your information will be used for no other purposes.

Date(Required)