Scholarship Application 2017
Purpose of Scholarship:
Church Hill Activities & Tutoring (CHAT) joyfully encourages students to pursue higher education and
certification programs. These awards are to provide financial assistance to a student interested in continuing
their education. Scholarships are awarded based on students’ stated financial need and application
information (see rubric).
Eligibility:
Students who meet the following criteria are eligible to apply for the scholarship:
1. Have been active in CHAT at some point from preK-12th
​ ​ grade.
2. Either currently enrolled as a full-time high school student, a student in current certification program,
Community College or 4- year
​
institution, ​OR provide a personal statement of intent for future
enrollment in a program of study.
Applicant must submit:
1.
2.
3.
4.
5.
6.
Completed application form
Typed essays
Two recommendation forms (see attached forms)
Most recent report card
Letter of acceptance, proof of application, or a personal statement of intent for enrollment, and
Copy of FAFSA and/or Financial Aid Award
Selection Process:
All scholarship applications are due by ​Tuesday, April 4,​ ​2017. ​Applicants will be notified of the committee’s
decision starting on ​May 15, 2017.
Awards:
The scholarship amounts are based on designated scholarship donations received by CHAT during the
2016-2017 fiscal year. Donations are fully tax deductible.
Questions:
If you have questions or need further information, please contact Mallory Hansen at mallory.hansen@
churchhillacademy.org or Gina Maio at ​[email protected]​ or both at 804.222.8760.
Page 1 | 7
APPLICATION
Directions: Complete following directions (see rubric at end for exact expectations). All three parts must be
received on or before April 4, 2017.
Part One: Personal Information
Name (first, middle, last): _____________________________________________________________________
Mailing Address: ____________________________________________________________________________
Student Phone:_______________________________ Parent phone: __________________________________
Student Email:______________________________________________________________________________
ACT Score*: ________________________
SAT Score*: _________________________
* If you have not taken either or both tests, please explain why and include with your application.
High School: ______________________________ Cumulative GPA: _______________________
College: (if applicable): ________________________________ College GPA: ______________________
Name of Institution you plan to attend: ________________________________________________
Have you applied for admission to this institution and been accepted? ______ Yes ______No
Have you completed any college or career planning sessions? _______Yes _______No
If yes, please describe:
Attach to this application:
(1) a copy of your most recent report card,
(2) a letter of acceptance, or proof of application, or a personal statement of intent for your educational
training, & (3) a copy of FAFSA and/or any financial aid awards.
Part Two: Essay​s
Directions: Write a one page (300 word) typed response to each of the following essay prompts. Please type
each essay on a separate sheet of paper, clearly labeling both the essay question and your name. (Times New
Roman 12 point font).
Option A: If you have ​never received ​a CHAT scholarship:
1. Describe in detail your financial needs. Please include examples of your actions to secure resources (for
example, the number of scholarships you have applied for, loans, employment, savings, etc.)
2. Describe your experience in CHAT. Give three detailed examples of CHAT’s impact on you.
3. If you could give anything back to your community, what would it be and why?
Option B: If you have​ ever received ​a CHAT scholarship in the past:
1. Describe in detail your financial needs. Please include examples of your actions to secure resources (for
example, the number of scholarships you have applied for, loans, employment, savings, etc.)
2. Describe how your past CHAT scholarship helped you achieve at least three specific goals. ​OR D​escribe
ways you have shared your college or training program experience with current CHAT youth (e.g. being
a CHAT summer intern).
3. Explain why you should continue to receive scholarship money from CHAT.
Submit Parts One and Two to Mallory Hansen, CHA Counselor, no later than Tuesday, April 4, 2017.
Page 2 | 7
Part Three: Recommendation Forms due by April 4, 2017
At least one month in advance, provide recommendation forms to two references. Explain the importance of
their information as well as the CHAT scholarship. Note the due date and instructions for delivering their
recommendation form.
Using the forms provided, you will need:
1. One letter from a mentor (not an immediate relative), preferably within the Church Hill Community,
and
2. One letter from your school personnel, for example a teacher, coach, or another staff person active
within your current school.
All recommendation forms must be received at CHAT for your application to be considered completed.
Please contact your references and make sure they send their forms directly to CHAT, either via email to
Mallory Hansen (​[email protected]​) OR by mail:
Church Hill Academy
c/o Mallory Hansen, CHA Counselor
2010 Carlisle Avenue
Richmond, VA 23231
Page 3 | 7
CHAT Scholarship Recommendation Form 2017 - Adult
Thank you for completing this recommendation. Your honest and insightful information is a vital part of
the scholarship process. For more information about CHAT please go to ​www.chatrichmond.org​.
1. Name of Applicant: ____________________________________
2. This form is due by April 4. Approximately how much time was provided by the candidate for you to
complete this form?___________________________________
3. How long have you known the applicant? _____________________________________
4. In what capacity have you known the applicant?
5. Your assessment of the applicant will help us in our evaluation of his/her application. Please rate
him/her on the following characteristics:
Excellent
Good
Characteristics
Fair
Poor
Creativity
Professionalism
Leadership
Dependability
Interpersonal
Relationships
Diligence
Other:
6. Please share, in 250 words or less, why this applicant should be considered for this scholarship.
Attach to this form.
7. Finally, are you aware of any reason (please signify if based on rumor or fact) that this student
should not be a candidate for a CHAT scholarship? Please explain completely and attach to this
form.
Name: ________________________________ Title/Position: ________________________________
Email Address: ________________________________________
Signature: ____________________________________________
Please return this form to Mallory Hansen (804.222.8760) by Tuesday, April 4 either via email (complete and scan this form) to
[email protected] or by mail to CHA, c/o Mallory Hansen, 2010 Carlisle Avenue, Richmond, VA 23231. You
can also bring in person to Church Hill Academy.
Page 4 | 7
CHAT Scholarship Recommendation Form 2017 - School
Thank you for completing this recommendation. Your honest and insightful information is a vital part of
the scholarship process. For more information about CHAT please go to ​www.chatrichmond.org​.
1. Name of Applicant: ____________________________________
2. This form is due by April 4. Approximately how much time was provided by the candidate for
you to complete this form?___________________________________
3. How long have you known the applicant? _____________________________________
4. In what capacity have you known the applicant?
5. Your assessment of the applicant will help us in our evaluation of his/her application. Please rate
him/her on the following characteristics:
Excellent
Good
Characteristics
Fair
Poor
Creativity
Professionalism
Leadership
Dependability
Interpersonal
Relationships
Diligence
Other:
6. Please share, in 250 words or less, why this applicant should be considered for this scholarship.
Attach to this form.
7. Finally, are you aware of any reason (please signify if based on rumor or fact) that this student
should not be a candidate for a CHAT scholarship? Please explain completely and attach to this
form.
Name: ________________________________ Title/Position: ________________________________
Email Address: ________________________________________
Signature: ____________________________________________
Please return this form to Mallory Hansen (804.222.8760) by Tuesday, April 4 either via email (complete and
scan this form) to [email protected] or by mail to CHA, c/o Mallory Hansen, 2010 Carlisle
Avenue, Richmond, VA 23231. You can also bring in person to Church Hill Academy.
Page 5 | 7
CHAT Scholarship Application Point System 2017
Directions:​ The following point system will be used by the CHAT Scholarship Committee to rate each
scholarship application. The total points awarded are one factor used by the committee when determining
scholarship recipients and scholarship award amounts.​ Failure to at least “meet expectations” will likely result
in not receiving a scholarship.​ ​ ​The Committee hopes that knowledge of this point system will inspire students to
strive to exceed our expectations.
Part I: Overall Application
Needs
Improvement
Timeliness
(includes
recommendation
forms)
Needs
Improvement
Needs
Improvement
Meets expectations
Exceeds
Expectations
Many items
late
1 point
Most items on time
2 points
All items on time
(including
recommendation
forms)
4 points
All items
submitted
before due date.
5 points
C-D grades
1 point
C overall
2 points
B-C overall
3-4 points
A-B overall
4-5 points
Application
typed, well
organized and
professional.
5 points
Cumulative Grade
Point Average
Incompletes/ F
grades
0
Application format
and presentation
Application
lacked neatness,
organization
0
Application mostly
neat and organized.
Not typed
1-3 points
Application neat and
organized. Typed.
Committee had
to request items
from student
0
Application
completed per
instructions. Some
delivery issues.
1 points
Application complete
and delivered
following directions.
2 points
Application
completeness
3-4 points
Application
exceeds
instructions or
directions
3 points
Part II: Recommendations
Information provided on the recommendation forms serves to offer greater insight and discernment to
Scholarship Committee members. The information itself will not be awarded points.
Recommendation forms were provided 1
week before April 1. Form was not
explained nor formally requested by
student.
Recommendation forms were
provided 2-3 weeks before April 1.
Purpose and importance of form was
expressed by student.
0-1 points
2-3 points
Recommendation forms indicate each
was provided to writer by March 1.
Purpose and importance of the
recommendation was fully explained by
student. In addition, recommendation
was formally requested by student in a
professional manner.
4-5 points
Page 6 | 7
Part III: Essays: The following will be used to evaluate all essays.
Needs Improvement
Meets Expectations
Exceeds Expectations
Content
Student does not answer essay
question. Or, answer does not
meet expectations nor offer a
complete answer. Overall, essay
is weak, lacking specific
examples and detailed
descriptions.
“Not enough”
0-1 points
Student sufficiently answers
essay question. Meets all
expectations and completes
directions. Overall, answer is
adequate, with examples
and details.
“Just enough”
2-4 points
Student thoroughly and
thoughtfully answers essay
question. Student may even
exceed stated expectations and
directions. Overall, essay examples
are extremely detailed, thoughtful,
inspiring and insightful.
“More than enough”
5-7 points
Writing
Mechanics
Complete
sentences,
grammar,
spelling,
proofread
Student writing has over 7
grammatical, punctuation, and
spelling errors. Most likely not
proofread or edited.
1 point per essay
Student may have proofread
and/or edited the essays.
Only 4 to 6 total
grammatical, punctuation,
and spelling errors.
2 points per essay
Student has thoroughly proofread
and/or edited the essays. Only 3 or
less grammatical, punctuation and
spelling errors.
3-4 points per essay
Format
Topic sentences,
indentation and
Paragraphs
Essay lacks basic paragraph
format--lack of topic sentences,
indentation, or create
paragraphs.
0 points
Student has topic sentences.
Student indents and creates
at least 3 paragraphs of 5-8
sentences each.
2-3 points per essay
Student has topic sentences that
are clear and guide the reader in a
purposeful direction. Student
indents and creates at least 3-4
clear and well developed
paragraphs of 5-8 sentence each.
Professionally presented.
4-6 points per essay
Page 7 | 7