10th Annual William F. King Jr. Scholarship

10th

5th Annual William F. King Jr. Scholarship

Annual William F. King Scholarship Chevron Corporation Black History Awareness Scholarship Chevron Richmond Black History Awareness Scholarship Letter of Recommendation Form 2015 Application Student Profile

Please Print Name:

Email Address:

Date of Birth: ___________________________________________

Gender:

□ Female

□ Male

Home Address: City: Phone Number: (

State:

Zip:

)

High School Name: Address: City:

State:

Are you a child or dependent of a current Chevron employee?

Zip:

□ Yes* □ No

(* Children of current Chevron employees and/or contractors are not eligible for this scholarship)

How did you hear about this scholarship?

□ College Counselor □ Academic Advisor □ Other (please specify) ________________________

Which colleges or universities are you interested in attending in 2015? (List your top 3 choices): 1)

State: _______

2)

State: _______

3)

State: _______ 1of 4

Extracurricular & Community Service Profile Describe your leadership activities and experiences:

hrs/wk #-wks/yr

1.

2.

3.

4.

5.

Describe your community involvement and extracurricular activities:

hrs/wk #-wks/yr

1.

2.

3.

4.

5.

Essay Write a 500-750 word essay on ONE of the following two topics. Write your name and essay topic number in the top left corner of the essay. Attach your double spaced, typed essay to your application. Essays will be judged on content, originality, creativity, grammar, and punctuation. Note: Scholarship Recipients’ are not eligible to receive more than one Diversity Chevron Sponsored Scholarship.

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1. How has African American and/or African Diaspora culture affected your life, your families’ life, or someone else’s life? 2. What lesson or event in African American and/or African Diaspora culture will you use to enrich your future? 3. How has the African American and/or African Diaspora culture enhanced your leadership skills within your community, include your community contributions. Essay Write a 500-750 word essay on ONE of the following two topics. Write your name and essay topic number in the top left corner of the essay. Attach your double spaced, typed essay to your application. Essays will be judged on content, originality, creativity, grammar, and punctuation. Note: Scholarship Recipients’ are not eligible to receive more than one Diversity Chevron Sponsored Scholarship.

4. How has African American and/or African Diaspora culture affected your life, your families’ life, or someone else’s life? 5. What lesson or event in African American and/or African Diaspora culture will you use to enrich your future? 6. How has the African American and/or African Diaspora culture enhanced your leadership skills within your community, include your community contributions.

Required Letter of Recommendation Include a reference letter from your teacher, coach, community leader, pastor, etc. that references your leadership, community involvement, and extracurricular activities. Provide attached “Letter of Recommendation” form (page 4) to your recommender.

GPA Disclosure I hereby certify the information provided in this application is, to the best of my knowledge, true and correct. I authorize the Scholarship Committee to have access to my school file to validate my GPA. Please have your school counselor or registrar sign the application to verify the validity of your GPA, > 2.5.

Cumulative G.P.A.:

Student Signature

Date

Counselor or Registrar’s Signature

Date

Mailing & Deadline Information All application components must be mailed in one package and must be postmarked on or before January 10, 2014 Late or incomplete applications will not be considered. Please consult your college counselor or advisor for submission directions. You may either submit your application to your College Counselor/Advisor, or email it directly to:

[email protected] Chevron Corporation Black History Awareness Essay Contest Attn: Michael R. Adams 100 Chevron Way, Bldg. 71-7534 Richmond, CA 94801 Winner Notification – Fourth Week of January 2015 3of 4

APPLICATION CHECKLIST

The student is responsible for submitting all materials on time. Incomplete applications will not be evaluated. This application becomes complete and valid only when the scholarship committee has received all of the following materials:    

Student Application Essay Letter of Recommendation GPA Verification

Postmarked on or before

December 19, 2014

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10th Annual William F. King Jr. Scholarship Chevron Richmond Black History Awareness Scholarship Letter of Recommendation Form (Provide this form to your recommender)

Applicant’s Name ______________________________________________________________

Instructions to Applicant You must provide a current, confidential letter of recommendation. The letter may be from an instructor, advisor, coach, community leader, pastor, etc. The letter cannot be from a relative. You should fully apprise your recommender about the William F. King Scholarship and your reasons for applying. Allow your recommender at least two weeks to write the letter. Submit the sealed recommendation with your application by the December 19, 2014 postmark deadline.

Instructions to Applicant’s Recommender The person named above is applying for a William F. King scholarship. This scholarship is administered by Chevron’s Richmond Black Employee’s network. Please type your letter of recommendation on letterhead stationery of your professional or organizational affiliation. We request your candid, written evaluation of the applicant relative to the following: o o o o

Academic record Academic plans and career goals Personal strengths, including motivation, leadership, and commitment Community service and extracurricular activities

The scholarship review committee will use your observations as part of its selection process. The applicant will benefit most from a specific and illustrative evaluation rather than a general assessment. The evaluation should discuss the applicant's strengths and, as appropriate, provide insight to any areas for growth. Please share what criteria you base your judgment upon and how the applicant meets those principles. Please complete the information below and return this form and your signed letter of recommendation to the student in a sealed envelope. The scholarship committee appreciates your assistance. Recommender's name __________________________________________________________________ Date ______________________ Professional title ______________________________ Professional/Organizational Affiliation _____________________________________ Address ________________________________________________________________________________________________________ City _________________________________________________________________ State _________ Zip code ___________________ E-mail _________________________________________________________________ Phone (

) _________________________

How long have you known the applicant? ______________________ In what capacity? _________________________________________

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