Fort Worth Claims Association Scholarship Information
For Sons and Daughters of Members.
- Application and all supporting documents must be received by the Program Administrator no
later than June 30th for the Fall Semester and December 30th for the Spring Semester.
NOTE FAXES WILL NOT BE ACCEPTED.
- Applicants must be children, stepchildren, or a child for which you are a legal guardian
- Applicants must be high school seniors, high school graduates, or college students
- Applicants must have a parent, stepparent, or guardian who are active members of the
association. Active is defined as attending at least 50% of the monthly meetings.
- Scholarships are awarded on the basis of academic achievement, education goals,
career goals, and participation in school and community activities, as well as the active
member status above.
- Each scholarship provides up to $1,000.00 per semester for tuition, fees, books and
other course-related expenses for students pursuing an associates degree or bachelor's
degree at an accredited college or university.
- Scholarship awards may be renewed, for up to four years, provided recipients maintain
eligibility, a satisfactory academic record, and a written request is made for renewals.
Renewal request must include a letter of accomplishments and goals along with the most
recent transcript. Eligibility will require the recipient to maintain a 2.5 grade point average
per semester.
- Applicants can only receive a scholarship for one of the two metroplex Claims Associations,
either Dallas or Fort Worth.
- Applicants are evaluated according to the following criteria
1. Official Academic TRANSCRIPT record-high school and/or college
2. SAT or ACT scores
3. School and community activities and honors
4. 250 word Essay
5. 2 Academic and 2 personal recommendations
All Applicants must follow the directions and all applications must be received by the due
date to the proper person for consideration.
You may contact any officer in the Association for questions you have on any of the above information.
For More Information Contact
FWCA SCHOLARSHIP PROGRAM ADMINISTRATOR
Jo Lowe
Texas Health Resources
611 Ryan Plaza Drive, Suite 200
Arlington, TX 76011
Jo Lowe, Program Administration, at
817-462-7273
______________________________________________________________
CHECK LIST OF INSTRUCTIONS FOR SCHOLARSHIP APPLICANTS
Thank you for interest in the F.W.C.A. Scholarship Program. Enclosed is an application
form and below are instructions for completing the application process. Please follow
these instructions and return your application by the due date. Late applications will not
be accepted.
- Complete the application form and Shool/Community Activity Sheet
- Attach your 250 word essay
- Arrange for your official high school transcript(s) AND, if applicable, your official college
transcript(s) to be sent directly to the address below. Unofficial transcripts will not be accepted.
- Provide your most recent SAT or ACT scores on your official transcript or send them directly
to the address below. If scores are listed on your official transcript, this is acceptable.
- Arrange for two academic recommendations and two personal recommendations to be sent
directly to the address below. Recommendations should be from persons listed on your application.
- The application form and all supporting documents must be received by the Program
Administration no later than June 30 for the Fall Semester and December 30th for the Spring Semester.
FAXES WILL NOT BE ACCEPTED.
SEND APPLICATION & SUPPORTING DOCUMENTS TO:
FWCA SCHOLARSHIP PROGRAM ADMINISTRATOR
Jo Lowe
Texas Health Resources
611 Ryan Plaza Drive, Suite 200
Arlington, TX 76011
Jo Lowe, Program Administration, at
817-462-7273
______________________________________________________________________
APPLICATION
Fort Worth Claims Association Scholarship
Section I - To be completed by the MEMBER: Please P R I N T or T Y P E
___________________________________________________________________
Name
___________________________________________________________________
Address City, State
___________________________________________________________________
Wk. Ph.# Hm. Ph.#
___________________________________________________________________
MEMBERS STATEMENT: ''I hereby declare that the individual named below is my
natural child, step-child, legally adopted child or foster child.''
_____________________________________ ___________________________
Signature Date
_______________________
Section II - To be completed by the APPLICANT:
_______________________________________________________________
Name DOB
________________________________________________________________
Social Security #
________________________________________________________________
Home Address City, State, Zip
________________________________________________________________
Other Address City, State, Zip
________________________________________________________________
Name of School You Are Currently Attending Date Attendance Began
_________________________________________________________________
Address of School City, State, Zip
_________________________________________________________________
Have you applied for FWCA Scholarship before? _____ yes _____ no
List below the name and addresses of other schools you have attended (including high schools,
colleges, universities or vocational schools) and the dates of your attendance. If you need
additional space to list schools you have attended, please attach your listing to the application form.
_____________________________________________________________________________
Name of School Dates of Attendance
_____________________________________________________________________
Address of School City ,State, Zip
_____________________________________________________________________
Name of School Dates of Attendance
_____________________________________________________________________
Address of School City, State, Zip
_____________________________________________________________________
Section III
In what class will you enroll __ Freshman __Sophmore __ Junior __ Senior
Name the school(s) to which you have applied for acceptance or, if you have already been accepted
or are presently attending, the school you plan to attend for the 2005/2006 academic year.
_________________________________________________________________________
What is (will be) your major?___________________________________________________
List your work experience, including the name of your employer(s) and your job title(s):_______
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
List the names and titles of individuals who will provide recommendations: with personal and academic
1.___________________________________________ Title/________________________________
2.___________________________________________ Title/________________________________
3.___________________________________________ Title/________________________________
4.___________________________________________ Title/________________________________
_________________________________________________________________________________
Section IV
Complete the attached sheet noting your school and community activities, awards & recognition.
________________________________________________________________________________
Section V
Write an original essay, approximately 250 words in length. Your essay may be handwritten or typed
and must be attached to this application form.
ESSAY TOPIC- What event or experience in your life has meant the most to you so far?
__________________________________________________________________________________
Section VI
Complete the following listing with your past and current high school, college and community activities:
1. Academic Record
Honors Course Year 1,2,3,4 Name of Course Final Grade
__________ _______________ __________
__________ _______________ __________
__________ _______________ __________
__________ _______________ __________
__________ _______________ __________
__________ _______________ __________
__________ _______________ __________
__________ _______________ __________
2. Leadership
Class Officer ____ 1 2 3 4 Office ________________________
1 2 3 4 Office ________________________
1 2 3 4 Office ________________________
1 2 3 4 Office ________________________
1 2 3 4 Office ________________________
Band ____ 1 2 3 4 Leadership________________________
ROTC ____ 1 2 3 4 Rank ________________________
1 2 3 4 Rank ________________________
1 2 3 4 Rank ________________________
1 2 3 4 Rank ________________________
Student Council/member _____
Student Government 1 2 3 4 Officer ________________________
1 2 3 4 Officer ________________________
1 2 3 4 Officer ________________________
1 2 3 4 Officer ________________________
Team Captain/Leader
Sports _____ Sport___________ 1 2 3 4 __Captain
Sport___________ 1 2 3 4 __Captain
Sport___________ 1 2 3 4 __Captain
Cheerleading _____ 1 2 3 4 __Captain 1 2 3 4
Newspaper Staff _____ 1 2 3 4 __Editor 1 2 3 4
Yearbook Staff _____ 1 2 3 4 __Editor 1 2 3 4
Clubs _____
Club _________________________ 1 2 3 4 Officer_______________
Club _________________________ 1 2 3 4 Officer_______________
Club _________________________ 1 2 3 4 Officer_______________
Club _________________________ 1 2 3 4 Officer_______________
Performance/Plays: ______ 1 2 3 4 ____________________________________
Chorus ______ 1 2 3 4
Girls Scouts ______ 1 2 3 4 ___Leader 1 2 3 4
Boy Scouts ______ 1 2 3 4 ___Leader 1 2 3 4
Specialties: Eagle/Gold etc. Honor/Position_____________________________
Church Youth Group _____ #of years____ Position_________________
Special Activities: ________________________________________________________
Choir _____ #of years_______
Civic Group(s) _____ #of years_______ Group___________________________
Special Activities:________________________________________________________
Volunteer Work _____ What type?__________________________________________
FWCA SCHOLARSHIP PROGRAM ADMINISTRATOR
Jo Lowe
Texas Health Resources
611 Ryan Plaza Drive, Suite 200
Arlington, TX 76011
Jo Lowe, Program Administration, at
817-462-7273