Katy-AM-Club-Scholarship-Application-2021-LOCKED

Katy A&M Club

2021 Scholarship Application

KATY A&M CLUB
2021 SCHOLARSHIP APPLICATION
PLEASE use electronic form from katyamc.aggienetwork.com to
complete online then print.
MAIL APPLICATION TO:

Scholarship Committee
Katy A&M Club
P.O. Box 6112
Katy, TX 77491-6112

DEADLINE: Application must be received by March 25, 2021.
ELIGIBILITY:
Applicants must live in and receive education within the Katy ISD
boundaries, and be a senior who has applied for admission to Texas A&M
University for the Fall 2021 semester. This includes home schools and
Private Schools within the boundaries of the Katy ISD.
Please attach the following: 1) one letter of recommendation, 2) a
copy of your high school transcript through fall semester Senior
year, and 3) your SAT and/or ACT score report.
NOTE: Please use the “Tab” key on your keyboard to navigate from
one field to the next.
Name:
     
Last

     

     

First

M.I.

Address:

Soc. Sec. #:       -       –

     

City:      

Zip:      

e-mail address:      
Telephone: (     )       -      
  

Age:      
  

  

Date of Birth:
Mo Day Yr

High school you currently attend:      

When did you apply for admission to TAMU?   
     
Mo

  What is the status of your application?

Yr

APPLICANT'S AGREEMENT AND CERTIFICATION
If I am selected,
 The Katy A&M Club may publicly disclose and publicize the non-financial
information in this application (e.g., grades, class standing, extracurricular
activities, etc.).
 I understand that the Club's goal is to assist as many students as possible with
available funds. Therefore, I agree that the Club may withdraw my scholarship,
in whole or in part, if I receive significant financial assistance from other
sources.
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Katy A&M Club

2021 Scholarship Application

 Upon request, I will provide updated family financial information and complete

information about other financial aid.
 I will provide the Club an electronic color photograph of myself within five days

of being notified.

I certify that the information in this application is true, correct, and
complete to the best of my knowledge.
Applicant's Signature

Date:

Parent's or Guardian's Signature

Date:

A.

HIGH SCHOOL CURRICULUM AND PERFORMANCE

When will you graduate?      
     

Estimated rank in class:

      out of

Mo Yr

Estimated grade average this semester:       Last semester average:      
Grading Scale: A =       points
Score:      

SAT Score:      

What college major(s) and/or minor(s) do you plan to study?      

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ACT


Katy A&M Club

2021 Scholarship Application

REMEMBER: Attach a letter of recommendation, a copy of your
high school transcript, and your SAT and/or ACT score report.

Page 3 of 7


Katy A&M Club

2021 Scholarship Application

B. FAMILY INCOME
Father/Stepfather/Guardian's Name:      
His Employer:      
Years with this employer:      
Position/job title:      
Mother/Stepmother/Guardian's Name:      
Her Employer:      
Years with this employer:      
Position/job title:      

Adjusted Gross Income (AGI) as reported to the Internal Revenue Service.
EST 2021

Father
/
Guardian
Mother /
Guardian
Total or
Return

2020

2019

Stepfather

/

$     

$     

$     

Stepmother

/

$     

$     

$     

Joint

$     

$     

$     

Parents’

Are you willing to provide documentation of the above amounts if requested?
Yes
No
Please list any other financial support (e.g., child support, trust fund, social
security, etc.) that will be available to you.
Source

Annual Amount

     

$      

     

$      

     

$      

     

$      

Other financial information you wish to be considered:
     
Family Information
Is either natural parent deceased?

Yes

No

Are parents separated or divorced?

Yes

No

If so, is parent living with you remarried?

Yes

No

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Katy A&M Club

2021 Scholarship Application

Siblings supported by your family:
Name
Class/Grade

Age

     

     

     

           

     

           

     

           

     

           

     

Total amount of financial aid that siblings receive from outside sources: $      
Other dependents in your family:
Name

Amount of
Support Given

Relationship

     

     

$

     

     

     

$

     

     

     

$

     

Other family information or special needs you would like considered:
     

Other Scholarships
Have

you
applied
Yes
No

for

other

scholarships

Scholarship or Sponsoring Organization
Status or Result

or

financial

Amount Applied For

     

$      

     

     

$      

     

     

$      

     

     

$      

     

     

$      

     

     

$      

     

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assistance?


Katy A&M Club

2021 Scholarship Application

C. WORK EXPERIENCE, EXTRACURRICULAR ACTIVITIES, COMMUNITY
INVOLVEMENT, AND LEADERSHIP
Are you employed?

Yes

No

If so, how many hours per week do you work?      
Please describe the kind of work have you done.

     
Do you have unusual home care responsibilities?
describe.
     

Yes

No

If yes, please

List your most significant extracurricular activities and leadership positions
(athletics, clubs, organizations, church, civic, etc.) and the length of time involved
in these activities and/or in a leadership position.
      
      
      
      
      
      
      
      
      
      

List any awards, honors, or officer positions held in your activities (both scholastic
and extracurricular) and the length of time in a leadership position.
      
      
      

      
      
      
      
      
      

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Katy A&M Club

2021 Scholarship Application

D. ESSAYS AND LETTER OF RECOMMENDATION
Attach one letter of recommendation from your principal, a teacher, or a
community leader.
Describe your career goals and vocational objectives.
     
Describe a significant experience or situation in your life that you feel has shaped
your outlook, abilities, or academic credentials.
     
Explain why you want to continue your education at Texas A&M University.
     

REMEMBER: Attach a letter of recommendation, a copy of your
high school transcript, and your SAT and/or ACT score report.

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