MILITARY IMPACTED SCHOOLS ASSOCIATION (MISA) - 2021 SCHOLARSHIP FUND APPLICATION
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MILITARY IMPACTED
SCHOOLS ASSOCIATION
(MISA)
2021 SCHOLARSHIP FUND
APPLICATIONThe Militar Impacted Schools Association (MISA) facilitates and a ards merit-based
scholarships for eligible students of all acti e-dut militar members attending a current
MISA School District. To be eligible students shall be entering a field of education in their
college of choice.
Eligibilit :
1. The applicant must be enrolled full-time in a public school district that is currentl a member
of the Militar Impacted Schools Association (MISA). (List of School District MISA Members
included.)
2. The applicant must be a high school senior ho ill graduate during the 2020-2021 school
ear.
3. The applicant must be accepted or e pect to be accepted b an institution of higher education.
4. The applicant must agree to enroll as a full-time student as defined b the
uni ersit /college during the 2021-2022 academic ear.
5. Applicants must ha e an o erall GPA of 3.0 or higher on a 4.0 scale.
6. The application must be completed and be in accordance ith the guidance pro ided in
this application (See page 2 of this application packet.)
7. The applicant must ha e signed the Ackno ledgement of Conditions on page 4.
8. The completed application must be digitall submitted ia email to: barbsadams@gmail.com on or
before March 26, 2021.
● Completed applications should be sa ed in .PDF format and submitted as an email attachment.
● Subject line of submitted email should be: MISA/2021 Scholarship/Last NAME
● .PDF Application Document should be sa ed as: Last Name-First Name-2021
9. Each applicant ma not be a arded more than one scholarship from the MISA Scholarship
Committee in a lifetime.
Selection Process:
1. MISA ill ackno ledge receipt of all applications ia email.
2. Eligible applications ill be for arded to the Selection Committee for re ie .
3. The MISA E ecuti e Board decides the number of scholarships and a ard amounts each ear
based on the amount of funds designated for distribution b the MISA E ecuti e Board. The
2021 a ard shall be ten scholarships of $2,000.00.
4. Notification of a ards ill be mailed b the end of April 2021.
5. The selection process is based on the number of alid and complete application packets recei ed.
Note: All information referencing name, age, gender, race, and other information that could be used to
identif the applicant ill be remo ed prior to ie ing b the selection committee.
1Scholarship Application Guidance:
1. Summar of applicant education/e perience/essa :
a. Distinctl separate each categor
b. T pe and double-space all responses.
c. Do not put our name on these pages.
d. List points of contact for reference here applicable.
2. Essa : Not to e ceed 350 words. Essa s ith more than 350 ords ill be recogni ed ith 0
points in the selection committee re ie ing process.
3. Follo the instructions in each section carefull .
4. The application must be sent digitall ia email on or before March 26, 2021. An application
checklist is a ailable on page 8.
5. If ou ha e an questions concerning the application process, please email the MISA
Scholarship Chair at barbsadams@gmail.com.
6. An recipient ho accepts a full-tuition scholarship or an appointment to a ser ice academ is
not eligible to recei e a MISA scholarship. It is the responsibilit of the recipient to notif the
MISA Scholarship Chairperson, in riting, to decline the MISA scholarship.
7. An scholarships that are declined or unclaimed b December 31, 2021 shall remain in the
MISA Scholarship Fund. The MISA E ecuti e Board ill determine ho those funds ill be
used.
2MISA Scholarship Applicant Information
Please t pe or print a response for each section belo . Incomplete applications ill not be
for arded to the Selection Committee.
APPLICANT S Name, Address, Telephone Number and Email Address:
LAST FIRST MI
STREET
CITY STATE ZIP
PHONE EMAIL
Active Dut Militar Member s Full Name, Address, Telephone Number and Email Address:
LAST FIRST MI
STREET
CITY STATE ZIP
PHONE EMAIL
3ALL APPLICANTS MUST READ AND SIGN THE FOLLOWING:
1. Privac Act Statement:
The enclosed personal information ill be maintained b MISA for administrati e use and
released onl to the indi iduals needing to e aluate the application. The disclosure of the
information b the applicant is oluntar ; ho e er, failure to disclose all or part of the
requested information ma hinder e aluation of the application.
I certif that the information in this application is true and correct to the best of m
knowledge. I understand that I will be disqualified if I have included false information in
this application. I agree to abide b the conditions of the MISA Scholarship Fund and the
decision of the MISA E ecutive Board Selection Committee and in no wa shall question
their selection of the winners and alternatives.
2. Acknowledgement of Conditions for the MISA Scholarship:
a. These scholarships are for tuition-related or direct school cost e penses onl . The
a ard ill be made directl to the academic institution upon receipt of an official
school erification of student enrollment form sent from the registrar s office.
b. Scholarship mone ill be a ailable for use beginning ith the Fall 2021 term.
An funds not claimed b December 31, 2021 ill be forfeited.
c. A ards declined ill be returned to the MISA Scholarship Fund and used at
the discretion of the MISA E ecuti e Board.
d. If the eligibilit criteria, including scholarship application guidance, are not met,
the application ill not be for arded to the Selection Committee.
e. Each applicant ma not be a arded more than one scholarship from the
MISA Scholarship Committee in a lifetime.
APPLICANT S SIGNATURE DATE
4Summar of Applicant Education/E perience/Essa
Distinctl separate each categor listed belo and then pro ide a complete response. T pe and
double-space all responses.
Categor 1: Schools Attended
In chronological order, beginning ith the most recent, list all schools ou ha e attended since Grade 9. Please
use the follo ing format:
School name- Location of school- Dates attended- Graduation date/Projected date (if applicable)
If ou ha e begun taking college credits, note after the dates attended the number of credits ou ha e
completed. If ou ha e completed a GED, note that information under school name, and note the date the
degree as a arded.
EXAMPLES:
H ,K 2014-2017 G P M 2018
C C ,K A 2017- 6
Categor 2: School/Volunteer Activities and Leadership Positions Held
In chronological order, list all school and olunteer acti ities ou ha e participated in during the last four ears.
Include the number of hours per month spent participating in these acti ities. List points of contacts for reference
( here applicable). Acti ities ma include, but are not limited to the follo ing: art, athletics, band, church
acti ities, clubs, communit acti ities, communit ser ice, debate, dramatics, school ne spaper, student
go ernment, and earbook.
EXAMPLES:
C C H M 2016-M 2017 4 / C
H M G ,K M 2016-J 2017 8 /
In chronological order, list all leadership positions held and a ards/honors earned during the last four ears.
Include the place and dates for hich the position as held.
EXAMPLES:
, C C H M 2017-M
2018 C , F H A -N 2017
E , 123 ,K M 2017
5Categor 3: Emplo ment E periences
In chronological order, list all emplo ment e periences ou ha e had during the last four
ears, including self-emplo ment opportunities if applicable. Include the dates each position
as held, a brief description of the position, and the number of hours orked per eek.
EXAMPLES:
M K D -I R L ,K 15
/ M 2016- M 5
M O L M ,K 40 /
( )J 2015- M 3
Categor 4: Hobbies/Interests
List all hobbies/interests that ou ha e not mentioned in pre ious categories. Describe the
hobb and length of time ou ha e been in ol ed ith the acti it .
EXAMPLES:
P .I 2013. I , ,
.
C .I .
Essa Response
Using a separate sheet of paper, answer the question below in 350 words or less. The
Selection Committee ill consider format, grammar, and creati it hen scoring the essa . For
additional essa guidance, please refer to Scholarship Application Guidance on page 2.
Essa Question: Describe a positi e e perience or an influential educator in one of the
schools ou attended that has impacted our decision to pursue a career in education.
6High School Guidance Counselor s Report
To complete this form, please t pe or print neatl .
APPLICANT S NAME: __________________________________________________
HIGH SCHOOL NAME AND ADDRESS: ________________________________________
APPLICANT S GRADE POINT AVERAGE (ON A 4.0 SCALE):_____________________
APPLICANT S ACT TEST SCORE: _____________________________________________
APPLICANT S COMBINED SAT SCORE: ________________________________________
(Math + Writing)
COUNSELOR S NAME:________________________________________________________
COUNSELOR S PHONE:_______________________________________________________
COUNSELOR S EMAIL:________________________________________________________
COUNSELOR S SIGNATURE:___________________________________________________
Date Report Completed: _________________________________________________________
Please Note: In order for the applicant to be considered b the selection committee, the student s
completed application must be emailed to the MISA Scholarship Committee on or before March 26,
2021. Please return this form to the applicant hen completed.
7Militar Impacted Schools Association Scholarship Fund
Application Checklist
All applicants must read, initial, and sign/date the follo ing checklist to ensure the application is
complete and properl submitted. Incomplete or improperl submitted applications WILL NOT be
for arded to the MISA Scholarship Fund Selection Committee.
INITIAL HERE:
______ The applicant s parent/guardian/sponsor, is an acti e-dut militar member in good standing
as of December 31, 2020.
______ Completed the MISA Scholarship Applicant Information on page 3.
______ Read and signed the Privac Act Statement and Acknowledgement
of Condition of the MISA Scholarship on page 4.
______ Completed the Summar of Applicant Education/E perience on pages 5 & 6 according to
the instructions. Please proofread all ork.
______ Included our response to the essa question on page 6. Essa s over 350 words will not
be forwarded to the selection committee. Please proofread all ork.
______ Included the High School Guidance Counselor s Report found on page 7.
______ The completed application packet must be emailed on or before March 26, 2021.
LATE APPLICATIONS WILL NOT BE ACCEPTED.
______ I accept that the decisions rendered b the MISA Scholarship Committee are final.
An email notification ill be sent once the packet is recei ed.
APPLICANT S SIGNATURE:___________________________________________________
DATE:________________________________________
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