GEORGE WASHINGTON CHAPTER, INC.
MODEL A FORD CLUB
2016 Scholarship Program and Application
General. The George Washington Chapter, Inc. (GWC) Model A Ford Club exists to unite
owners of Model A Fords and others who are interested in the restoration and preservation of
these automobiles. The purpose of this organization is to encourage and maintain a spirit of
good fellowship and fair play through sponsored activities that include the use of the Model A
Ford, and to encourage family participation. In pursuing this purpose, reference to the Model A
Ford shall include all aspects associated with the Model A Ford and its era, including
engineering, technical information, production, sales history, literature and era fashions.
The Scholarship Program. The club is prepared to award up to five (5) $1,000 scholarships
for the year 2016. Selection is based upon the applicant’s ability to meet the scholarship
requirements. Applicant(s) may be awarded only one scholarship during the course of the year,
and up to two (2) scholarships during the life of the program. Applicants must be either a
graduating high school senior or a current student in a school of higher learning (vocational
school, technical school, community or two year college, or a four year college or university).
The application process is described below, and requires the information specified in the three
(3) attached forms.
Applicant Requirements.

Applicant must be a member, child, grandchild or great grandchild of a member in good
standing of the GWC.

Applicant must have a B or better grade average to be eligible. Institution transcripts
must be submitted separately, but in conjunction with the application.

Application shall include at least two letters of recommendation from a teacher or person
knowledgeable of the applicant. Letters must be submitted directly from the
recommending individual to the Youth Development Chairman (see Attachment C).

Members of the Scholarship Selection Committee and their family members, and
applicants who have previously been awarded this scholarship two (2) times are not
eligible.

Submit applications and documents to: Youth Development Chairman, (Scholarship
Application), George Washington Chapter, Inc., 3903 Old Lee Highway, Fairfax, VA
22030, or email the applications and documents to: [email protected].
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
The application must be postmarked or filed on-line no later than May 2, 2016.
Incomplete applications may be disqualified.
Selection Announcements:

The Scholarship Committee Chairman will notify winners by both mail and phone.
Winners and/or their club sponsors/guardians should be present to receive the
scholarship award at the Sully Historic Site Car Show, Chantilly, VA on Father’s Day,
June 19, 2016. If this is not possible, the Committee will arrange for the presentation at
another designated event.

Scholarship checks will be made out to the school or institution unless other
arrangements are made with and approved by the Scholarship Committee.
Decisions of the Scholarship Committee are final. The scholarships offered by the George
Washington Chapter, Inc. are equal opportunity scholarships. No decision made in awarding
these scholarships will be based on gender, race, color, religion, national origin, disability, age,
sexual orientation or ancestry. The George Washington Chapter, Inc. is a not-for-profit 501(c)7
organization.
Thomas Quigley
Youth Coordinator
703-615-9109
Attachment A: Scholarship Application Format Instructions
Attachment B: Application Form
Attachment C: Information for Letters of Recommendation
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Attachment A
GEORGE WASHINGTON CHAPTER, INC.
MODEL A FORD CLUB
SCHOLARSHIP APPLICATION FORMAT INSTRUCTIONS
To:
Date:
Youth Development Chairman
(Scholarship Application)
George Washington Chapter, Inc.
3903 Old Lee Highway
Fairfax, VA 22030
Or email the applications and documents to: [email protected]
SUBJECT: 2016 GWC Model A Ford Club Scholarship Application
1. Applicant’s Name:
2. Contact Information
Mailing address:
City, State, Zip code:
Email address:
Home telephone/cell phone:
3. Parent/Legal Guardian and Sponsor name and contact information:
Parent/Guardian name(s):
Mailing Address:
City/State/Zip Code:
Email address
Home telephone/cell number
Sponsor’s name and relationship:
Mailing Address:
City/State/Zip Code:
Email address
Home telephone/cell number
4. Institution or training facility you will be attending. (NOTE: This is used to make payment if a
scholarship is awarded. If you know the bursar or finance office address, please include it).
5. Provide the most recent transcript of your grades: (NOTE: this is used to verify that you
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have at least a “B” average). Send this transcript to the Youth Development Chairman by
separate mail or email message. Note that class rank is not a selection criterion for this
scholarship.
6. Reference and recommendations:
a. Include at least two independent recommendations in support of your application.
Distribute the recommendation format found at Attachment C to teachers, counselors,
administrators and/or members of your community.
b. Recommendations must be post-marked no later than May 2, 2016, and mailed or
emailed to the Youth Development Chairman. Recommendation letters should be mailed directly
by the person making the recommendation.
7. Community service: List community service projects in which you are or have been involved
and describe your participation in each. List current community service projects first.
8. Extra-curricular school activities: List academic, athletic, club or other activities in which you
are or have been involved, and describe your participation in each. List current activities first.
9. Extracurricular non-school activities: List activities or clubs in which you are or have been
involved (e.g. scouting, music, art, church and/or job), and describe your participation. List
current activities and/or clubs first.
10. Model A Ford knowledge and participation: Describe your involvement with the Model A
Ford and/or participation in any Model A Ford Club event(s). Provide information about your
involvement with the sponsor who qualifies you for this scholarship.
11. Goals: Please provide the reviewers some insight into your short term or long term goals.
12. Applicant’s name, signature, date and contact information:
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Attachment B
GEORGE WASHINGTON CHAPTER, INC.
MODEL A FORD CLUB
SCHOLARSHIP APPLICATION FORM
To:
Date:
Youth Development Chairman
(Scholarship Application)
George Washington Chapter, Inc.
3903 Old Lee Highway
Fairfax, VA 22030
Or email the applications and documents to: [email protected].
SUBJECT: 2016 GWC Model A Ford Club Scholarship Application
1. Applicant’s Name:
Mailing Address:
City/State/Zip Code:
Email address:
Home telephone/cell number:
2. Parent/Legal Guardian and Sponsor name and mailing addresses:
Parent/Guardian:
Mailing Address:
City/State/Zip Code:
Email address:
Home telephone/cell number
Sponsor’s name and relationship
Mailing Address:
City/State/Zip Code:
Email address
Home telephone/cell number
3. Institution or training facility you will attend:
4. Provide the most recent transcript of your grades: (see Attachment A, paragraph 5)
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5. References and recommendations: (see Attachment A, paragraph 6)
6. Community service:
7. Extra-curricular school activities:
8. Extracurricular non-school activities:
9. Associations and experiences with the Model A Ford:
10. Goals:
11. Applicant name, signature and date, contact information:
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Attachment C
GEORGE WASHINGTON CHAPTER, INC.
MODEL A FORD CLUB
SCHOLARSHIP APPLICATION
LETTER OF RECOMMENDATION PREPARATON INFORMATION
Respondents - Please include the following as a minimum:
Date prepared:
To:
Youth Development Chairman
(Scholarship Application)
George Washington Chapter, Inc.
Youth Development Chairman
(Scholarship Application)
3903 Old Lee Highway, Fairfax, VA 22030
Or
Email the applications and documents to: [email protected]
SUBJECT: 2016 GWC Model A Ford Club Scholarship Application
Insert your testimonial or observations. Include the applicant’s name. Please explain your
relationship with the student.
To be considered, all recommendations must be post-marked no later than May 2, 2016.
Submitted by: (Include name, address and title)
-----------------------------------------------------------------------------------------------------------------------------About the George Washington Chapter, Inc.
The George Washington Chapter, Inc. (GWC) Model A Ford Club exists to unite owners of
Model A Fords and others who are interested in the restoration and preservation of these
automobiles. The purpose of this organization is to encourage and maintain a spirit of good
fellowship and fair play through sponsored activities that include the use of the Model A Ford,
and to encourage family participation. In pursuing this purpose, reference to the Model A Ford
shall include all aspects associated with the Model A Ford and its era, including engineering,
technical information, production, sales history, literature and era fashions.
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