Fredamae Schaefer Wise Scholarship

Fredamae Schaefer Wise
Scholarship Fund

Deadline: April 29, 2009

The Fredamae Schaefer Wise Scholarship Fund is a trust established by Lester Schaefer of Mikkalo and administered by the B.P.O. of Elks Lodge No. 1869 of Condon, Oregon.

This trust is used to provide scholarship gifts for the benefit of any person who has graduated from a high school in Gilliam County and is working toward a baccalaureate degree, and academic award, or a certificate of an undergraduate nature offered by any college, university, or technical school.

It is the wish of the trustier that two scholarships be given each year – one to a boy and one to a girl (not to be given twice to the same person). The amount of each scholarship will constitute one-half of the income from the trust. In recent years, approximately $350 has been awarded to each scholarship recipient.

This scholarship will be judged equally on aptitude and financial need. The deadline for it to be completed and turned is on or before April 29, 2009.

Complete applications should be mailed before the deadline so that they will reach the following person by that date:

Ron Kopp
c/o Condon High School
PO Box 575
Condon, OR 97823-0575

For more information, or if there are any questions,
please contact Ron Kopp at 384-2441 during the day
or at 384-3212 during the evenings.
Thank you!

FREDAMAE SCHAEFER WISE
SCHOLARSHIP FUND

IMPORTANT: Before preparing this application, it is recommended that the procedures outlined on back page be carefully studied and then completely executed.

Name: Social Security #:
Address: Phone:

Date of Birth: Place of Birth:
Age: Sex: Citizenship – American: YES NO
If not born an American citizen, give date and place of Naturalization.
Date: Place:

Schools attended (ninth through twelfth grades):

Name of School Date of Entrance Period Attended

Date will graduate: Number in Class:

Rank in Class: G.P.A.:

Date: , 20

Signature of Student

TO BE COMPLETED BY UNMARRIED APPLICANTS DEPENDENT ON PARENTS:

Father’s Name: Age: Occupation:
Mother’s Name: Age: Occupation:

Parent’s Marital status: Mother: Married: Widowed:Divorced: Remarried:
Father: Married: Widowed: Divorced: Remarried:

Father’s annual income before taxes: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $
Mother’s annual income before taxes: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $
Applicant’s annual income before taxes: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     $

All other taxable or non-taxable income not included above:
(including pensions, Social Security/disability, interest, dividends, etc.) . . . . $
GROSS Income (Total of Above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Number of Dependents (excluding mother and father) . . . . . . . . . . . . . .
Number of Dependents attending college in 2007-2008 . . . . . . . . . . . . .

Last Year's Medical and Dental expenses not paid by insurance . . . . . . . . . . . . . . . . . . $
Emergency expenses (flood damage, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Total Market Value of Home $                   Amount of unpaid mortgage . . . . . . . $
If no home is owned – amount of annual rent . . . . . . . . . . . . . . . . . . . . . . . . . . . .   $
Do you own a business or farm? ___Yes ___ No   If so, what is market value?         $
What is the net profit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Value of bank accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Value of other investments (CDs, stocks, bonds, etc.) . . . . . . . . . . . . . . . . . . . . . . $
Any unusual circumstances, please explain:

Does Mother or Father have a pension plan other than Social Security? Yes No

TO BE COMPLETED BY MARRIED OR INDEPENDENT STUDENTS:

Applicant’s marital status Single Married

Spouse’s name: Age:Occupation:

Applicant’s annual income before taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Spouse’s annual income before taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

All other taxable or non-taxable income not included above

(including pensions, Social Security/disability, interest, dividends, etc.) . . . . $
GROSS Income (Total of Above) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

Number of Dependents (excluding applicant and spouse) . . . . . . . . . . . .
Spouse attending school . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes No
Number of other Dependents attending School/College. . . . . . . . . . . . . .

2007 Medical and Dental expenses not paid by insurance . . . . . . . . . . . . . . . . . .   $
Emergency expenses (Detail) . . . . . . . . . . . . $
Total Market Value of Home $                   Amount of unpaid mortgage . . . .        $
If no home is owned – amount of annual rent . . . . . . . . . . . . . . . . . . . . . . . . . . . .    $
Do you own a business or farm? ___Yes ___ No   If so, what is market value? $
What is the net profit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           $
Value of bank accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           $
Value of other investments (CDs, stocks, bonds, etc.) . . . . . . . . . . . . . . . . . . . .       $
Any unusual circumstances, please explain:

College or School planning to attend:
Address:
Date course will begin: Date course will end:
Educational Goal (Give name of course of study:
At completion of course, I will receive a Certificate, Diploma or a Degree (type of degree)
Employment record (employer, address, dates of employment, person to contact about employment, position):

Honors and Awards – School related (Scholastic, athletics). Do not use initials for the groups in these following sections, to
which you belong or have belonged:

Honors and Awards – Non-school related (Civic):

Offices or positions held (Organization, position, year):

Other activities (School or Civic):

TO BE COMPLETED BY ALL APPLICANTS
Budget for full Academic Year of How many months?
Tuition and Fees (full academic year, not monthly) . . . . . . . . . . $
Books and Supplies . . . ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Room and Board (only if living on campus) . . . . . . . . . . . . . . . . $
Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .....$

= $

LESS ANTICIPATED INCOME:

Parent’s Contribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Student’s Contribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Summer Earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
College Work/Study Employment. . . . . . . . . . . . . . . . . . . . . . . . . $
Other Scholarships, Grants, or Loans (detail):

= $

Amount needed to balance school budget for the year . . . . . . . . . . $

= $

In order to properly evaluate this application, the information on the next page is essential. Select the area that best fits the applicant’s circumstances. A dependent applicant is one who relies on his/her parents for the basic and major part of his/her support. An independent applicant is one on his/her own and derives the basic and major part of his/her support from himself/herself and/or a spouse. Incomplete information in this area will disqualify an applicant.

Fredamae Schaefer Wise Scholarship
- GENERAL INSTRUCTIONS –

1.       Applications and all supporting documents must be in English or English translations.
2.       Letters may be originals or photocopies on one side of a single 8 ½” X 11” paper singed by the author.
3.       Official transcript of student’s records from the beginning of the 9^th grade to due date of application may be photocopies that bear an original signature f the proper school authority.
4.       CEED, SAT, and ACT tests scores or related equivalent. If applicable, must be included but may be photocopies. It is preferable that exhibits such as award and certificates be photocopies.
5.       All applications must be properly bound on the left side with hinges or staples in a standard binder or cover. Elaborate bindings are discouraged. Clear plastic or bulky covers are undesirable.
6.       The application must be arranged in the order described below:

a. Application of Required Facts. Carefully plan a response to each item before typing in the final draft. By year, identify appropriate scholastic, extra-curricular and civic activities. Secure all required dates.

b. The applicant shall prepare a statement of 300 words or less setting forth his/her vocational or professional goal and relate how past, present and future activities make the accomplishments of this goal probable. The applicant by deed and circumstance must demonstrate his/her worthiness. The letter must be signed.

c. The parent/guardian shall prepare a statement of 200 words or less summarizing the family’s obligations and resources, The statement needs to illustrate the applicant’s need for financial assistance and the inability of the family to satisfy these needs. The statement must be signed.

d. Official singed transcript of high school grades.

e. College entrance test scores required (CEEB or Act or SAT or related equivalent).

f. Current, dated, signed one-page letter of recommendation from at least three people, but not more than four in authority from high schools attended by the applicant, or workplaces where applicant has been employed. Letter may cover the applicant’s ability, work habits, leadership, personality, integrity, participation in community in terms of work service, leadership, notable skills and outstanding recognition. Each letter should be typed, dated, signed and no more than one side of 8 ½” X 11” page.

g. Copies of exhibits of achievement in scholarship, leadership, athletics, dramatics, community service or other activities may be attached but the applicant should avoid begin repetitious.