WATKINS MILL HIGH SCHOOL PTSA - BOOSTER SCHOLARSHIP APPLICATION
Name ________________________________________________________________________________________________________________________
Student ID Number ___________________________________________________________________________________________________________
Male / Female
Address___________________________________________________________________________________________________________________________________
Street Address
City
Zip Code
Home Phone ________________________________________Cell Phone _________________________________________________________________
Email Address _________________________________________________________________________________________________________________
Elementary school ______________________________________________ Middle school ___________________________________________________
Are you a member of Watkins Mill High School PTSA and/or Booster Club?
Are you planning on pursuing an education major in college?
Are you a member of Interact Club?
Office use only:
GPA ______________
Yes / No
Yes / No
Yes / No
Weighted GPA ______________
Number __________________
Community Service Hours ______________
2016
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WATKINS MILL HIGH SCHOOL PTSA - BOOSTER SCHOLARSHIP APPLICATION

Please type or print legibly in black or blue ink.
 You must be a member of the PTSA – Booster Club to be considered for the any of the PTSA – Booster Club scholarships. A student membership is
sufficient; you must join by April 7, 2016.
You can sign up on line at http://wmhsboosters.com/, or you can fill out the form attached to this application and attach your $5 membership
fee.
 You may add your resume to this application, but you cannot substitute your resume for the Leadership/Activities section. You must still complete
that section in full.

The deadline to turn in this application is April
7, 2016 at 3:30 PM. Return your completed application to the Career Center.
       A partial list of the available scholarships is at the back of this page       
Number __________________
2016
WATKINS MILL HIGH SCHOOL PTSA - BOOSTER SCHOLARSHIP APPLICATION
A partial list of the available scholarships for which you will be considered:
Criteria
Organization
Boy MVMS alum
Montgomery Village Middle School PTSA
Girl MVMS alum
Montgomery Village Middle School PTSA
Neelsville alum
Neelsville Middle School PTSA
South Lake alum
South Lake Elementary School
Stedwick alum
Stedwick Elementary School
Watkins Mill alum
Watkins Mill Elementary School
Whetstone alum
Whetstone Elementary School
Interact member
Rotary Club of Montgomery Village Interact
Rotary Club of MV
Montgomery Village Foundation – the number and amounts of these
scholarships vary depending upon the amount of donations the MVF
receives
Brian K. Betts Foundation *additional essay required
Dede Burrell
Community service
Montgomery Village resident, academic achievement, community
service
Pursuing a degree in education
Academic Achievement, Community Service
Academic achievement
Bethany Presbyterian Church Scholarship
WMHS PTSA – the number and amount of these scholarships varies
depending upon the amount of money the PTSA raised during the school
year
Service to the school
Athletic achievement – boy
WMHS Booster Club
Athletic achievement – girl
WMHS Booster Club
Academic achievement – boy
WMHS Booster Club
Academic achievement – girl
WMHS Booster Club
School spirit – boy
WMHS Booster Club
School spirit – girl
WMHS Booster Club
Based on SSL hours
Booster Club SSL
Number __________________
Estimated Amount
300
300
250
150
500
300
300
750 renewable for four years
500 renewable for four years
Varies
2,000
500
1,000
Varies
500
500
500
500
500
500
300
2016
Activity
Please explain all your activities in this area including summer activities, whether you held a leadership position, and which years
you participated in each.
Academic
Achievement
List all of your academic
honors, awards, and
recognition
(Ex., honor roll, science student
of the month)
Community
Service
List all service to
community members or
organizations
(Ex., School service, church
choir, volunteer at hospital,
Scouting)
Community
Activities
Participation in social clubs,
athletics, religious and
community organizations
(Ex., church youth group,
summer swim team)
Number __________________
2016
School
Activities
Athletics, clubs, music,
drama, school publications
(ex. SADD, Interact,
chamber singers)
Employment
List the number of hours
worked per week and
whether you worked during
the school year and/or
during the summer
Number __________________
2016
WATKINS MILL HIGH SCHOOL PTSA - BOOSTER SCHOLARSHIP APPLICATION
Please submit a short statement – no more than 250 words – in which you describe your personal and educational goals and
the events that contributed to developing those goals. You may submit your statement on this sheet or on a separate paper.
Number __________________
2016
BRIAN K. BETTS MEMORIAL SCHOLARSHIP
PERSONAL ESSAY
Complete this essay only if you are applying for consideration for the Brian K. Betts Memorial Scholarship.
Instructions: Write an essay describing your educational and career goals and how you plan to achieve them. Limit your
response to 500 words or less. You may submit your statement on this sheet or on a separate paper.
Number __________________
2016
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Watkins Mill High School
PTSA | Booster Club Registration
Academic Year 2015-2016
FAMILY Membership Fee $30

INDIVIDUAL Membership Fee (select below)
Family membership for the PTSA and
Booster Club includes parent/guardians
and all WMHS students in your family.
Additional Donations
Parent/Guardian $15 
Student
$5 
Watkins Mill Staff $10 
PTSA $ ___________
Booster Club $ ___________
TOTAL Amount Paid $ ___________
Please make check payable to WMHS PTSA
Member Information
 Parent/Guardian
 Watkins Mill Staff
Adult Name
Email Address
fg
Phone
 Parent/Guardian
 Watkins Mill Staff
Adult Name
Email Address
Phone
Family/Student Mailing Address
Street Address
City & Zip Code
Phone
NOTE: Student membership is required to be eligible for 2016 PTSA / Booster Club scholarships.
Student Name
Class
of:
Email Address
Extracurricular
Activities/Sports
Student Name
Class
of:
Email Address
Extracurricular
Activities/Sports
Please mail or deliver completed form to Watkins Mill HS PTSA | 10301 Apple Ridge Road | Montgomery Village, MD 20879