John F. Motes Scholarship Application

Please read the following application carefully and complete all blanks. If information is not applicable, please note using N/A and explain why on the application.

Application and all related materials must be submitted between January 1st and January 31st.

Applicants name:

Date of birth:

Phone number:

Application type:

Active State Employee

Dependent of ASEA Member

Address:

Email:

Number of dependents:

ASEA member relationship:

Agency:

ASEA member full name:

Agency phone number:

College you plan to attend / currently attend:

High school GPA:

Planned course of study:

College GPA:

ACT test score:

SAT test score:

List, with dates, all high schools and college or trade schools attended, including your present school (beginning with most current):

List school, community, and work activities in which you have participated:

List all scholarships:

Scholarship Essay (250 words or less):

Upload transcripts, letters of recommendation, and any other applicable documents (PDF or JPG only):

Upload File

I certify that I have read and understand the guidelines contained herein. I attest that all information I have provided in this application is true.

Signature

Date

Thanks for submitting!

Complete bylaws regarding the John F. Motes scholarship fund can be found on our website at www.aseaar.org.