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Georgia Association of Zoning Administrators
GAZA
P. O. Box 1041
Jasper, GA 30143
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BETTY GECOMA SCHOLARSHIP APPLICATION

 

The Georgia Association of Zoning Administrators (GAZA) is pleased to award a $1,000 college academic scholarship each year to an entering Freshman or Upperclassman student who demonstrates superior academic achievements and has financial need. The scholarship is given in honor of Betty Gecoma, the founder of GAZA. The applicant must be an active GAZA member, or the child or grandchild of an active, retired, or deceased GAZA member. The scholarship will be awarded based on the information included in the application. Scholarship applicants may reapply for continued funding for up to a maximum of four (4) years, provided there is demonstrated academic progress and subject to review by the Scholarship Committee each year. Application submittals for the 2017-2018 academic year must be postmarked no later than May 31, 2017.

 

Name of Scholarship Applicant: ______________________________________________

 

Please mark one of the following selections as appropriate:
(     ) The applicant is an active member of GAZA.
(     ) The applicant is a child or grandchild of an active, retired, or deceased GAZA member. If so, name of GAZA member: ________________________________________________

 

Student Applicant Information:

Full Name: ________________________________________  Birthdate: ______________

Mailing Address: ____________________________________________________________________

City: _______________________________    State: ___________    Zip: _____________

Phone: __________________ 

Email: __________________________________________________________________

Are you currently enrolled in school?   Yes   No   If Yes, full-time or part-time? ____________________

Name and city location of current school: ____________________________________________________________

Latest reported grant point average from this school: __________

During which term? __________________

Latest reported test scores (as applicable):  SAT __________   ACT _____________

Year in school during current academic year (freshman, sophomore, etc) ________________________

Are you currently employed?    Yes    No    If Yes, where? ____________________________________

Honors received: ____________________________________________________________________

____________________________________________________________________

Memberships (clubs, fraternities, other extracurricular activities): ____________________________________________________________________

____________________________________________________________________

Hobbies / Interests: ____________________________________________________________________

____________________________________________________________________

List other financial sources for educational / living expenses, and note approximate annual amounts:

____________________________________________________________________

____________________________________________________________________

 

Parent or Legal Guardian Information: (if applicable)

Name(s): ____________________________________________________________________

Mailing Address: ____________________________________________________________________

Telephone: __________________  

Email: _______________________________________________________________

Place of Employment: ____________________________________________________________________

 

College or University Information:

Name of School and City Location: ____________________________________________________________________

Intended field of study or major: ____________________________________________________________________

 

Payment Information:

If the scholarship should be awarded to you, the following payment option will be utilized:

1. One-half of scholarship will be awarded when confirmation of class schedule showing full-time schedule is received.

2. One-half of scholarship will be awarded when class schedule showing full-time schedule is received within the next nine months of the original award.

 

Where should the check(s) be sent: Name & Address: 

___________________________________

___________________________________

___________________________________

 

Attachments:

Please attach each of the following items with this application.

A. Copy of most recent transcript or grade report (high school or college).

 B. Typed essay of between 100 and 500 words which answer the following questions:

     1. What are your career interests in Life?

     2. How does this determine your field(s) of study?

     3. And, why have you chosen these?”

 

I / we hereby certify to the best of my knowledge that all the information depicted on this application (including all attachments) is true and accurate. I / we agree that use of the scholarship funds shall be for enrollment or continuance of education in a recognized and / or accredited school such as a college, university, trade or technical school, business college, or others as may be approved by the Scholarship Committee. The funds shall be used for such purposes as tuition fees, books, school supplies, and other expenses while enrolled in the school.

__________________________________________     __________

Student                                                                            Date

__________________________________________     __________
Parent or Legal Guardian                                                   Date

 

Submit completed application to:

GAZA

PO Box 1041

Jasper, GA 30143