2024/25 Smith Scholarship Application

Scholarship Application Form

Application Deadline - January 22, 2025, 11:59 pm
Read and follow the instructions carefully prior to submitting your application. All winners will be notified on or before the 1st of May 2025.

1. AI in any form is prohibited!!! Ask Humans to proofread your application and use correct grammar and capitalization. AI will be deemed plagiarism and will disqualify your application.

2. This is not a writing competition. Content is very important. We want to learn who you are as a person: your personal struggles, triumphs, education and professional goals.

3. If you have selected a university, and it is the only school you will attend, STOP. While the student’s choice, if academically based is a key factor, the BOT takes multiple factors into consideration in matching scholarship recipients to a school or schools.

4. SSF has a REQUIRED event called “Boot Camp.” The event is mandatory for new scholarship recipients and will occur on Sunday, June 1st in Birmingham, AL. Boot Camp is an all-day event. If you cannot attend this event, please do not submit an application.

Thank you for your honesty and SSF encourages you to continue to pursue your academic endeavors.

After completing your application, you will be notified of award. You will be asked for documentation to support the data you provide.
Likewise, all correspondence and award agreements will be generated from the personal information submitted below.

The undersigned hereby acknowledges the information provided on this application, including attachments, is true and correct to the best of his/her knowledge, and the information may be provided and disclosed to the Smith Scholarship Foundation, to the officers and trustees of the Foundation, and to any other person authorized by the Foundation to review the information.

Personal Data
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Mobile No*

Area CodePhone Number
Email *
NOTE: Use an email address where you can securely receive mail. You may want to use an alternative mailing address of a friend or teacher depending on your circumstances.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of High School:*
Date of Graduation*

MonthDayYear
Date
High School Address* (Please list the Street Address, City, State, and Zip Code and County)*
High School Counselor’s Name*

First NameLast Name
High School Counselor’s Email* (NOTE: Many schools use software or filters that will block or send emails to spam. Make sure your counselor knows you have applied for the Smith Scholarship.)*
example@example.com
High School Counselor’s Phone Number*
Please enter a valid phone number.
Other High School Staff* If another high school staff member has assisted you, provide their name, email, and phone number. (NOTE: If personal emails or personal phone numbers are available, ask the Staff member if you can add these as well.

Disciplinary Violation:

NOTE: SSF programs require transparency and honesty. SSF understands students are not perfect and circumstances exist that create problems. It is paramount that the applicant explains the incident and acknowledges their mistake and demonstrates accountability.
Have you ever been held accountable for a disciplinary violation at any educational institution you have attended since the 9th grade (or the international equivalent), whether concerning academic or behavioral misconduct that led to disciplinary measures? These measures may include, but are not limited to, probation, suspension, removal, dismissal, or expulsion from the institution. (Please do not include tardiness or detention infractions. Answering "Yes" does not automatically disqualify you.)*

YesNo
If “Yes” please truthfully explain in detail.
Misdemeanor, Felony, or Other Crime
Have you ever been adjudicated guilty or convicted of a misdemeanor, felony, or other crime even if the judgment has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a court to be kept confidential?*

YesNo
If you answered "Yes," please provide a truthful and detailed explanation. (A "Yes" response does not automatically disqualify you, as we recognize that students can make mistakes and rules may be enforced inconsistently.)

Living Situation

NOTE: Some applicants have complicated home lives that do not fit well into a check-the box answer. Explain to the best of your ability your situation. All information is confidential.
Please Choose one of the following. (Living Situation)*

Homeless NOTE: If you do not have a regular residence or move from friends or relatives for shelter, you need to advise your counselor and register with the County Liaison for the “unaccompanied” or “at risk homeless” classification. This will make preparation of your FAFSA easier and possibly qualify you for additional financial aid.At Risk of being Homeless NOTE: If you are living with someone who has no legal obligation to care for you (i.e., a friend, extended family member, or teacher), you are “at risk” for homelessness. Please advise your counselor and register with the County Liaison for the “unaccompanied” or “at risk homeless” classification. (See Commonly Asked Questions). This will allow you to file FAFSA as an independent status expediting the process and possibly qualifying you for additional financial aid.Living with a different guardian NOTE: If you have been formally appointed a guardian or a close family member has served as your guardian for several years and a formal or informal agreement exists in which that person handles your affairs or supplies support.Foster Care/Group Home. NOTE: If you have been formally placed in foster care or reside in a group home, please use this classification as additional Educational Benefits may be available.Living with both parents.Living with one parent.

GPA and Testing Scores
GPA: (100 scale only) A minimum "C" average is required* (equivalent to a 75 average). NOTE: College Vine provides instructions for converting grades if your transcript does not use a 100-point scale. What is your high school GPA?*
Here's Help: https://blog.collegevine.com/how-to-calculate-your-gpa-use-this-step-by-step-guide
Transcript* Please upload a copy of the most recent transcript*

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ACT/SAT: (NOTE: A completed ACT or SAT is necessary to be eligible for the Smith Scholarship. Test scores are not "graded" but are utilized to identify subjects that might require remedial attention due to limited academic exposure. We encourage you to take the ACT multiple times to achieve the highest score possible and qualify for additional scholarships. Retaking the test is viewed positively in the evaluation of your application, as it demonstrates commitment and determination. Please consult your counselor or Upward Bound Program Director to request fee waivers. Have you taken the ACT or SAT?*

YesNo
If "No", please enter date you are registered to take the test.*

MonthDayYear
Date
How Many Times?*
How many times have you taken the ACT / SAT?
ACT/SAT Taken What is your ACT or SAT Score? *** Scores are used to ascertain academic areas that may require Remedial Assistance due to limitations on your educational opportunities. Applicants ARE NOT graded on Test Scores.*
Please upload your ACT or SAT Score.*

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Statement of Understanding
Statement of Understanding

VERY IMPORTANT
Scholarship Orientation: I understand that attendance is MANDATORY at the Scholarship Orientation ("Boot Camp") on Sunday, June 1, 2025 in Birmingham. Please take the time to adjust your schedule before you make your decision. (If you cannot commit to this date, your application may be terminated. Note: That no waivers will be granted.)*

YesNo, I can not commit to this date.

Additional Scholarships
To qualify for this scholarship, students must APPLY for at least three (3) external scholarships before submitting this application on January 10th.

All college scholarship applications must be submitted to the designated institutions by their respective deadlines, and you should keep proof of submission for the three or more additional scholarships. If you become a Finalist, you will need to provide this proof. If you have previously applied for other scholarships, kindly list the names of the applications you have submitted.

If you have not yet applied for outside scholarships, please visit our website for links to additional scholarship opportunities and complete your applications before submitting the 2024-25 Smith Scholarship application.
*******Please list at least 3 Scholarships that you have applied for and their deadlines. *
(ABS- Local Scholarship- December 5th, 2024)

Service
Have you performed Community or Civic Volunteer Service?*

YesNo
Where did you volunteer?*
Organization's Contact Name and Number? *
Where did you volunteer?*
Organization's Contact Name and Number? *
Where did you volunteer?*
Organization's Contact Name and Number? *
Please list any additional volunteer or community services performed.*

Awards and Activities / Leadership

Have you received recognition for Academic, Leadership,Volunteer Work, or Sports?
NOTE:

What clubs, organizations, sports teams, bands, and pep squads are you a part of?

Why do these activities hold importance for you?

Describe your experiences, such as striving for 1st chair, guiding a diverse group to produce a newspaper or yearbook, or coordinating a talent show.

Consider the personal significance of these endeavors. What inspired you to spend all night crafting those banners, just to see the football team break through them?

Please list each activity with the corresponding year (one per line).
School Activities: Please list each activity, including the year and your position (one per line). Additionally, describe the organization's mission and purpose, along with your involvement and any leadership roles you held.*
Please list each award and include the year of the award (one per line).
NOTE: Why is this meaningful to you?

Example: Do you teach Sunday School or coach little league or youth soccer?

Share stories of both successes and the mishaps, like children running the bases backward. Have you ever run for office, worked on a candidate's campaign (large or small), advocated for change, participated in a protest, or collected relief supplies?
Non-School Activities (Religious/Church/Political): Please list each activity, including the year and your position (one per line). Additionally, describe the organization's mission and purpose, along with your involvement and any leadership roles you held.*

Essay Questions
* It is essential to review and proofread your work for organization, spelling, grammar, and content. Aim for a minimum of 500 words, with a preference for 1000 words.

Be sure to include personal, educational, professional details, and specific plans to achieve them.

NOTE: While it is wonderful to have big dreams, it is also important to outline a backup plan for a secure future in case you are not chosen as the next Voice winner.

Creating a timeline for your goals shows that you have conducted thorough research and understand the education, training, or certifications needed to reach your aspirations.
Essay #1: What is your greatest strength or talent? *

0/1000

Essay Questions
It is essential to review and proofread your work for organization, spelling, grammar, and content. Aim for a minimum of 500 words, with a preference for 1000 words. In it, please discuss your goals for college and your chosen major, as well as how you plan to utilize your education after graduation. Explain the significance of the scholarship to you. Additionally, highlight any academic and non-academic achievements, personal traits, or experiences that make you a strong candidate for scholarship consideration.

* NOTE: Everyone has a unique talent; if you are unsure of yours, consider asking a friend for insights.

Are you someone who listens with empathy, always ready to be there for others?

Do you step up and take charge when others seem unsure where to begin?

Are you a natural leader, a dependable team player, and someone who follows directions effectively?

These qualities are just as valuable as being the standout star of the week. Share examples and describe experiences that showcase your strengths; highlighting your talents is encouraged.
Essay#2: What are your plans, goals, or aspirations?*

0/800

Personal Statement
This is the most crucial section of your application. Take the time to outline your thoughts before you start writing to ensure your story is well-organized and effectively communicates the information and emotional journey that has shaped you and influenced your plans.

When providing sensitive information that you wish to keep confidential, please label it as Confidential. SSF takes necessary precautions to protect the applicant's information.
Provide an essay of "Your Story". (The Good, The Bad, Happy or Sad.) Explain your identity, family life, or special interest. How has your past inpacted who you are today? Your application should paint a holistic picture of who you are, touching on all aspects of your life whether as a student, volunteer, athlete, grandchild, sibling, leader, artist, cook, worker, dancer, or survivor. *

Additional or Supplemental Essay

If you would like to attach any additional essays or writing samples or artwork of your choosing, we encourage you to add them to your application. If you have other talents such as singing, provide us a linkto your YouTube posting.
Please elaborate on the following points:

- AP Courses (include test scores if relevant)
- Career Counseling programs, such as TRIO and Upward Bound
- Dual Enrollment (specify the school, courses, and your GPA)

NOTE: This is your chance to showcase your creativity and share written work you take pride in, as well as any artistic expressions that reflect your personality and interests.

Have you engaged in any college preparedness programs? This can include those at school, online, or in other settings.
Please explain.*

CERTIFICATE OF NEED
Employment
Are you employed?*

YesNo
Where do you work?*
Work Contact Name and Number? (John Doe- 203-555-1212)*
What do you use your earnings for? (Household expenses, cellphone, car payments)*
In what ways do you provide financial support to your family? (Paying utilities, purchasing groceries, etc.)*
How do you contribute to your household? Keep in mind that many families depend on each other to keep their finances and daily activities running smoothly.*
Please be detailed in your explanation.

Parents' Information
Mother's Name*

First NameLast Name
Date of Birth*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Mother's Employer*
Mother's Occupation*
NOTE: This helps SSF understand both the financial and stability resources of the applicant.
Mother's Level of Education: (City College- BA- Education)*
NOTE: Parents’ education level is often a factor in your educational experience and personal expectations of college

Father's Name*

First NameLast Name
Date of Birth*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Father's Employer*
Father's Occupation*
NOTE: This helps SSF understand both the financial and stability resources of the applicant.
Father's Level of Education: (City College- BA- Education)*
NOTE: Parents’ education level is often a factor in your educational experience and personal expectations of college
Please note: If you lack information about your mother or father, kindly explain the circumstances. Many applicants prefer to keep family dynamics private, but SSF needs to understand each applicant's situation to effectively review your application and assess its impact on your education.
Responses such as "Unknown," "N/A," or "Not in My Life" will not be accepted unless accompanied by specific details. If your parent is deceased, has abandoned their parental responsibilities, is incarcerated, or struggles with mental illness or addiction, please provide that information.

Step Parents

Stepparents refer to current stepparents who are either married to a parent or are in a long-term partnership with a parent, regardless of whether there is a legal marriage.
Do you have a stepparent?*

YesNo
How many years has your stepparent lived with and/or been married to your parent?*
Does the stepparent provide you with financial or physical support? Please provide detailed explanations when responding to the specific questions about them on the application.*

YesNo

Siblings
How many Siblings do you have?*
NOTE: The number of siblings, cousins, or school-age members in the household reflects the applicant's responsibilities, obligations, time commitments, and financial constraints. Please list all household members, regardless of whether they are actual relatives.
Please give the names and ages of your brothers and sisters, or any other individual attending school in your household.

• If they are enrolled in grades K-12 (or the international equivalent), list their grade level.

• If they have attended or are currently attending college, give the names of the undergraduateinstitution, degree earned, and approximate dates of attendance.

• Please list the annual cost of people in your housing attending a school of any kind (daycare,kindergarten, high school fees, community college or college.)
School Attendance (Joey Doe- 6, 1st Grade, Jane Doe- Troy University, Current, 2022- Present.)*

Household Dynamics

The number of people in your household, including applicant.
NOTE: Many applicants live with extended family members by choice or necessity. This information assists in clarifying family dynamics,and financial and family obligations to help those residing in the household. Please list the numbers in your household.*
Household Information
One person per line. .*
Please list the name, ages and occupations of those individuals in your household.
Is anyone in your household disabled, handicapped, or has special needs?*

YesNo
If yes, provide the name of individual(s), relationship, type of disability, special needs, and who provides currentfinancial and physical aid. One person per line. (Example: Jane Sibling- Special Needs- Medicare.)*
Has anyone in your family experienced serious health issues that result in significant medical expenses? Note that chronic conditions and unexpected health emergencies can place a considerable financial burden and stress on the family. It is important for reviewers to understand how these circumstances impact the applicant, so please include details about co-pays for medical appointments and prescriptions, who accompanies the individual to doctor visits, and who assists with daily care.*

YesNo
Please explain the assistance provided.*
Does anyone in your family receive child support or aid for dependent children?*

YesNo
If “Yes”, Who? And the Amount/Month? (John Little Brother, $500/ Month)*
1.). Name 2.) Condition 3.) Medical Cost / Pay Annually 4.) Caregiver
Does anyone receive alimony, spousal support, or property settlement payments?*

YesNo
If “Yes”, Who? And the Amount/Month*
(Mother- $1000/ Month- Alimony)

Letter of Recommendation
NOTE:

Applicant should contact individuals listed for letters of recommendation. Make certain they will respond by the APPLICATION DEADLINE.

Use people who know you and will be an advocate. Read the questions that will be asked in the LOR section. If your recommender will not be able to accurately answer, you should select another person or talk with the person who has been nominated.

Click open and Print form to hand deliver to Recommenders or copy link into and email and send directly to your Recommenders. *************

Below is the letter that will be sent to the person you designate as a Recommender:

"You have been nominated to provide a Letter of Recommendation on behalf of an applicant for the SSF Scholarship. Smith Scholars are selected based on perseverance and ability to overcome hardships.

Your responses to the following questions will assist the student in demonstrating these qualities. Letters of Recommendation are the primary source of information about the student. Most applicants advance to “Finalist” based upon the information and insight contained in your letter.

Many students sell themselves short in their applications; therefore, we rely on your letter to provide information demonstrating the student’s character, achievements, and personal triumphs.

Please attach a Letter or copy and paste it into the field below containing the following information."

Letter of Recommendation Helpful Guidelines.
Name of Recommender #1 *

First NameLast Name
Email Address (#1) of the Recommender.*
example@example.com
Phone Number of Recommender #1*
Please enter a valid phone number.
Letter of Recommendation #1
Letter of Recommendation #1 (Upload)

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Name of Recommender #2 *

First NameLast Name
Email Address (#2) of the Recommender.*
example@example.com
Phone Number of Recommender #2*
Please enter a valid phone number.
Letter of Recommendation #2
Letter of Recommendation #2 (Upload)

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Name of Recommender #3 *

First NameLast Name
Email Address (#3) of the Recommender.*
example@example.com
Phone Number of Recommender #3*
Please enter a valid phone number.
Letter of Recommendation #3
Letter of Recommendation #3 (Upload)

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Letter of Recommendation information guidelines.

·      Your Name.
·      How long have you known the applicant?
·      How do you know the applicant?
·      Describe the students'
·      Academic success
·      Academic struggles and effort to succeed academically.
·      Has the applicant overcome financial impediments by working to provide for personal expenses or family expenses?
·      Are you aware of any issues in the applicant’s home life that hinder or impede the student’s academic success?
·      Has the applicant overcome any disability or physical or mental health issues?
·      What character trait does the applicant possess that is holding the student back from reaching his/her full potential? (Low self-esteem or lack of self-confidence, trouble prioritizing, overcommitment to obligations?)
·      Describe the applicant’s empathy for others.
·      Describe any talents, extracurricular activities, or sports the applicant has participated in or examples of leadership skills.
·      Other. Add anything you believe is important for SSF to know about the applicant. Good-Bad or otherwise.
·      (You're welcome to use an existing LOR, however please also provide requested information on the student that follow our platform.)
·      Provide your letter to the student to upload, or email letter to kim@smithscholarships.net.

Signature*

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Applicant's E-Signature
By signing the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Date*

MonthDayYear
Date
Time

Hour Minutes

AM/PM Option
The Smith Scholarship Foundation is committed to equal opportunity in education. The Colleges selected does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Scholarship Application Form

Personal Data

Disciplinary Violation:

Misdemeanor, Felony, or Other Crime

Living Situation

GPA and Testing Scores

Statement of Understanding

University Assignment

College / University Choices

Additional Scholarships

Service

Awards and Activities / Leadership

Essay Questions

Essay Questions

Personal Statement

Additional or Supplemental Essay

CERTIFICATE OF NEED

Employment

Financial Aid

Note:

Parents' Information

Step Parents

Siblings

Household Dynamics

Household Information

Letter of Recommendation

Applicant's E-Signature