LARAMIE LDS ALUMNI, DESPAIN, AND WILLEY SCHOLARSHIPS APPLICATION

FOR HIGH SCHOOL SENIORS Graduating Spring 2011 Planning to attend UW, LCCC (Albany County Campus), or WyoTech

DEADLINE FOR ALL MATERIALS March 31, 2011

LARAMIE LDS ALUMNI, DESPAIN, & WILLEY SCHOLARSHIPS APPLICATION

This scholarship is for the 2011-2012 school year only. New applications must be submitted prior to each new school year and are not held over.

HIGH SCHOOL STUDENT INFORMATION

PRINT OR TYPE
Name _________________________________________________________
Last First Middle

_________________
Date

Address________________________________________________________
Street City State Zip

_________________
Phone

E-mail address_______________________________________ Are you a recipient of the Hathaway Scholarship? __________ What other scholarships have you applied for & their amounts? ___________________________________________________ ___________________________________________________ ___________________________________________________ High School Attended____________________________________ Graduation date________________ Religious affiliation ____________________If LDS -Ward___________________ Stake ___________ PLEASE INCLUDE: A one page letter explaining your need for this scholarship. I have read and I understand the Code of Honor on the reverse side of this page, and I agree to abide by these standards as a scholarship recipient. I also give my consent to the Scholarship Committee to use the information provided on all parts of this application when evaluating and awarding scholarships. Signed __________________________________________________ Date __________________

PLEASE RETURN COMPLETED FORM TO :

SCHOLARSHIP COMMITTEE LARAMIE LDS INSTITUTE OF RELIGION P.O. BOX 1205 LARAMIE, WY 82073-1205

DEADLINE FOR ALL APPLICATION MATERIALS MARCH 31, 2011

Visit our web site at www.ldsces.org/laramie

CODE OF HONOR
The Laramie LDS Institute of Religion of the Church of Jesus Christ of Latter-day Saints wishes to encourage students of the highest moral caliber to attend the University of Wyoming and help maintain an atmosphere supportive of the development of men and women who will champion the preservation of Christian ideals and principles. In accepting a scholarship, a person signifies a willingness to live by the following principles, whether on or off campus: 1. Abide by the standard of Christian living taught by the Church of Jesus Christ of Latter-day Saints. This includes graciousness and consideration of others and observance of high principles of honor, integrity, and morality. 2. Be honest in their behavior. This includes not cheating, plagiarizing, or knowingly give false information. 3. Respect the rights of others: This includes (a) not physically or verbally abusing any person and not engaging in conduct that threatens or endangers the health or safety of others: and (b) not obstructing or disrupting the study of others; the performance of official duties by University personnel; the teaching, research, disciplinary, administrative, or other functions of the University, or other authorized activities on University premises. 4. Respect property rights. This includes refraining from theft, damage, or misuse of the property of others. 5. Obey, honor and sustain the law. 6. Avoid drug use. This includes refraining from possession, use, or distribution of any narcotic or dangerous drug (as defined by law), except as prescribed by a licensed medical practitioner. 7. Comply with University of Wyoming regulations. This includes compliance with rules relating to campus organizations and to the use of University or off-campus housing or other facilities. 8. Observe the Word of Wisdom. This includes abstinence from alcoholic beverages, tobacco, tea, coffee, and drugs. 9. Be morally clean. This includes abstinence from all illicit sexual relations. 10. Observe high standards of taste and decency. This includes refraining from disorderly, lewd, indecent, or obscene conduct and expression. 11. Observe decent standards of dress and grooming. 12. Attend a class at the Laramie LDS Institute of Religion each semester. 13. Help others fulfill their responsibilities under this code.

LARAMIE LDS ALUMNI, DESPAIN, & WILLEY SCHOLARSHIPS APPLICATION

HIGH SCHOOL COUNSELOR INFORMATION
TO BE FILLED OUT BY STUDENT
Name _________________________________________________________
Last First Middle

_______-_____-______
Social Security #

Address________________________________________________________
Street City State

____________________
Zip Phone

TO BE FILLED OUT BY HIGH SCHOOL COUNSELOR / PRINCIPAL

High School Attended______________________________________ City _______________________________ State __________ H.S. Graduation Date____/____/____
Month Day Year

Test information:

ACT: Composite ________________ SAT: Total ________________ With difficulty

In your opinion, how well will this student perform in the university setting? Superior Above Average Satisfactory

Cumulative grade point average, in grades 9 - 12 ________ (on a 4-point system) High School honors received:

Extracurricular activities:

Offices held: Which indicates your overall evaluation of this student? Consider academic performance, citizenship, extracurricular involvement, and academic preparation for college: Highest 1% 5% 10% 15% 20% 30% 50%

NOTE:

ATTACH AN OFFICIAL HIGH SCHOOL TRANSCRIPT

Signed _____________________________________ Position ____________________ Date___________

RETURN COMPLETED FORM TO :

SCHOLARSHIP COMMITTEE LARAMIE LDS INSTITUTE OF RELIGION P.O. BOX 1205 LARAMIE, WY 82073-1205

DEADLINE FOR ALL APPLICATION MATERIALS MARCH 31, 2011

LARAMIE LDS ALUMNI, DESPAIN, & WILLEY SCHOLARSHIPS APPLICATION

BISHOP INFORMATION
TO BE FILLED OUT BY STUDENT
Name _________________________________________________________
Last First Middle

________________
Date

Address________________________________________________________
Street City State

________________
Zip Phone

TO BE FILLED OUT BY BISHOP

Church positions held last 3 years ________________________________________________________ ____________________________________________________________________________________ Student meets all worthiness standards Yes No Priesthood held: Elder Priest N/A Years of Seminary completed with credit Estimate of students financial need 1 YR 2 YRS No Need 3 YRS 4 YRS

Minor Need Major Need

BISHOP'S EVALUATION OF STUDENT Consider citizenship, extra-curricular involvement, general worthiness, and commitment to the Gospel. ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________

Bishops Name ________________________________________ Home Phone ___________________ Signed _________________________________________________________ Date _______________

RETURN COMPLETED FORM TO :

SCHOLARSHIP COMMITTEE LARAMIE LDS INSTITUTE OF RELIGION P.O. BOX 1205 LARAMIE, WY 82073-1205

DEADLINE FOR ALL APPLICATION MATERIALS MARCH 31, 2011 Visit our web site at www.ldsces.org/laramie