Oklahoma 2016
SCHOLARSHIP PROGRAM
RULES AND REGULATIONS
SCHOLARSHIP AWARDS
Panhandle Telephone Cooperative, Inc. shall award up to a total of twenty (20) scholarships for the year 2016 in
the amount of $1,000 each.
A committee composed of members of the PTCI Board of Trustees will make selection of the scholarship winners.
Scholarships will be awarded up to twenty (20) applicants who are, in the opinion of the committee, most worthy of
an award on the basis of scholastic record, future promise and financial need.
Announcement of the scholarships awarded will be made in early April of each year. Scholarship winners will be
required to accept such awards for use during the next succeeding school year.
ELIGIBILITY
Any graduating senior who resides with and is the child, adopted child, step-child, or full dependent ward of a
parent or parents in the certified service area of Panhandle Telephone Cooperative, Inc., may apply for one of the
scholarships available in his/her appropriate service area.
Students qualifying under the above provisions must also be qualified for admission to an accredited college or
university, or trade school at mid-term or at the end of the current school year during which the awards are made.
Graduating seniors who are not eligible to apply for said scholarships include any student who is a child, adopted
child, step-child, or full dependent ward of an employee or trustee of Panhandle Telephone Cooperative, Inc., who is
directly involved in the scholarship selection process.
Oklahoma 2016
APPLICATIONS
Applications for scholarships must be made on forms provided by PTCI and much be submitted to the offices of
PTCI by mail at PO Box 1188, Guymon, Oklahoma, 73942, or by delivery to PTCI at 2222 NW Highway 64, Guymon,
Oklahoma, no later than the date announced annually as the last date upon which application will be received. THE
SELECTION COMMITTEE MAY NOT CONSIDER APPLICATIONS POSTMARKED AFTER THE DATE SPECIFIED, NOR
MAY IT CONSIDER APPLICATIONS, WHICH DO NOT INCLUDE ALL MATERIALS, REQUESTED ON THE
APPLICATION. Deadline: No later than Friday, January 15, 2016
OBLIGATION OF SCHOLARSHIP HOLDERS
Scholarship holders will be required to maintain no less than a “C” grade average during their first semester of
study in order to receive the remaining half of their scholarship award.
Failure in and/or withdrawal from more than one-third of the total credit hours enrolled in for the first semester shall
forfeit any holder’s remaining scholarship funds. PTCI may make exception to the Rule, upon petition by the holder, if
absence from classes on account of illness, certified to by a physician, or other exceptional reasons, shall have been the
cause of such failure or withdrawal.
LIABILITIES AND RIGHTS
PTCI Board of Trustees, nor the scholarship selection committee shall be liable for the debts or conduct of holders
of scholarships, and such holders shall have no right to anticipate, assign or transfer rights acquired by reason of a
scholarship award.
The PTCI Scholarship Committee reserves the rights to at any time make any exceptions, interpretations,
modifications, and amendments to the provisions hereof as it deems appropriate.
Address all correspondence to:
PTCI Scholarships
PO Box 1188
Guymon, Ok 73942
Oklahoma 2016
All questions must be answered fully and accurately. Type or print in ink. Information contained in this application will be held
confidential.
Name _______________________________
Male _____ Female _____
Date of Birth _________________________
Marital Status: Single _____
Married _____
Address____________________________________________________________________
(Rural Route, PO Box, Street)
(City)
(State)
(Zip code)
Email Address: ____________________________Cell Phone No. _____________________
High School you will graduate from ____________________ Graduation date _________
Years in this high school ________
Name of college/trade school you plan to attend __________________________________
College entrance score: ACT_____ SAT _____
Course of study planned ________________________________________
FATHER or Legal Guardian
FAMILY INFORMATION
MOTHER or Legal Guardian
Name___________________________
Name______________________________
Address__________________________
Address ____________________________
Occupation ______________________
Occupation _________________________
Telephone No. ____________________
Telephone No. _______________________
Should you be selected as a scholarship winner, parents (for publicity purposes) should be listed as:
___________________________________________________________________________
Ages of children in household _______________________
Number of children in household currently attending college/trade school _______
(over)
Oklahoma 2016
ATTACH THE FOLLOWING INFORMATION: Please use separate pages for each item 1-6.
Please type using Arial 10 pitch without bold or italics. Please use only your initials at the top right hand side of each page.
Omit your name or contact information on each page.
1)
Please use separate page. List school activities, organizations, offices held, positions held and awards received during
high school. Omit your school name or acronym.
Examples
Football – 4 years – Captain
Basketball – 4 years
Band – 4 years Drum Major
Choir – 2 years
National Honor Society – 4 years
Team Sports First Aid Assistant
Class President – Freshman, Sophomore, Junior & Senior year
Student Council Class Representative Freshman, Sophomore, Junior & Senior year
2)
Please use separate page. List all community activities you are involved in outside of school, how many years you have
participated and your responsibilities (if any) in the activities.
Examples
Church Youth Group – Song Leader
Vacation Bible School Volunteer – Outside play activities or Baked cookies
4-H Local President 2011-2015
4-H County Vice-President 2013 & 2014
Local Food Bank – Worked at the food bank. Helped collect food for the food bank.
Local Homeless Shelter – Held a fundraiser 2014. Furnish or service a meal.
Mission trip to Guatemala – Held a week long bible school. Help build a school. Help build water system.
Relay for Life – Held a fundraiser. Or Team Captain of the Race for Cure.
Girl Scouts 2011-2015
Boy Scouts 2011-2015
3)
Please use separate page. List prior and present work/job experience and job duties/responsibilities.
4)
Please use separate page.
1. List scholarships you have received and amount of the scholarship received.
2. List scholarships you have applied for and the amount applied for.
5)
Please use separate page. This scholarship would not be sufficient to cover all costs of a college education. Explain
how you expect to meet the additional expenses.
6)
Please use separate page. Explain the goals you have set for yourself during and after college.
7)
Attach high school transcript. Attach college transcript if applicable. (MANDATORY)
ALL INFORMATION MUST BE PROVIDED IN ORDER TO BE CONSIDERED FOR SCHOLARSHIP.
I certify that all statements contained in this application are true and correct.
____________________________________ _____________________
Applicant
Date
Mail to: PTCI Scholarship Foundation
PO Box 1188
Guymon, OK 73942
Deadline: No later than Friday, January 15, 2016