MMPCIA Scholarship

MOUNT MORRIS PARK COMMUNITY IMPROVEMENT ASSOCIATION
PO BOX 3270
NEW YORK, NY 10027
212-369-4241
MMPCIA 2016 College Scholarship Application
Applicant Criteria
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1. Student must live in the Greater Mount Morris Park/Central Harlem Community from 110 to 135th
Streets between Morningside and 3rd Avenues.
2. Student must currently be a graduating senior.
3. Student must have a C+ (75% average) or better.
4. Student must demonstrate financial need via the “Application Print Summary” of the Free Application
for Federal Student Aid (FAFSA); including the calculated values (family income) and expected family
contribution (EFC). Please contact your guidance counselor for additional support and
information.
5. Student must provide evidence of community service during high school.
6. Student must have a confirmed acceptance to a two- or four-year college.
7. Student must provide three recommendations (see the application checklist on page 4 of the
application).
8. Student must write a 500-word essay on the topic provided.
9. All applications must be submitted electronically or postmarked via USPS on or before the published
deadline.
Student Information
Student Name___________________________________________ Date of Birth___________
Home Address_____________________________________________ New York, Zip_______
Home Phone (___ )___________________ Mobile (____) ________________________
Student’s High School__________________________________________
School Address______________________________ City/State/Zip____________________
Student’s Email:_____________________________________________________________
School Principal Email________________________________________________________
Guidance Counselor Email_________________________________________________
MOUNT MORRIS PARK COMMUNITY IMPROVEMENT ASSOCIATION
PO BOX 3270
NEW YORK, NY 10027
212-369-4241
MMPCIA 2016 Scholarship Application, Page 2
Parent Information
Parent/Guardian’s Name(s)______________________________________________________
Parent/Guardian’s Address (if different) from student’s)________________________________
Parent/Guardian’s Phone (___ ) ____________________ Email_________________________
Parent/Guardian
I agree to allow my child, to submit this application to the Mount Morris Park Community
Improvement Association Scholarship Committee.
Parent Signature__________________________________________ Date________________
Student Signature_________________________________________ Date________________
Community Service Description
Describe your most recent community service experiences in 250 words or less. Include this description
with your application. Please note: All MMPCIA scholarship recipients will be required to perform
community service during college.
2016 Essay Topic
Please write an original essay of 500 words or fewer on this topic:
How will this scholarship award help you to meet your education and career goals?
Include the essay with your application.
Filing deadline is June 15, 2016
Submit your complete application by email or via USPS to:
[email protected] or
MMPCIA 2016 Scholarship Committee
P.O. Box 3270
New York, NY 10027
MOUNT MORRIS PARK COMMUNITY IMPROVEMENT ASSOCIATION
PO BOX 3270
NEW YORK, NY 10027
212-369-4241
MMPCIA 2016 Scholarship Application, Page 3
Student Records Release Form
I, _______________________________, give my permission to the high school to which I am currently
attending, _________________________________________, to release my grades and attendance
records to the Mount Morris Park Community Improvement Association’s Scholarship Program. I
understand that these records will be kept confidential and used only for the MMPCIA Scholarship Award
Program.
Student Name_________________________________________________
Student Signature____________________________________ Date___________________
Parent/Guardian
Name(s)___________________________________________________________________
Home Address__________________________________________ New York, Zip________
Home Phone (____)____________________ Mobile (____)____________________
Parent/Guardian Signature_______________________________________ Date___________
MOUNT MORRIS PARK COMMUNITY IMPROVEMENT ASSOCIATION
PO BOX 3270
NEW YORK, NY 10027
212-369-4241
MMPCIA 2016 Scholarship Application, Page 4
2016 Application Checklist
Please use this list to make sure your scholarship application is complete.
______ All responses in this application are complete including all requested signatures.
______ A transcript of your grades is included with your application.
______ Three letters of recommendation, typed on letterhead, from the following individuals are included
with your application:
Your guidance counselor
One of your teachers
Someone in the community who knows you (preferably someone who supervised your community
service)
______ Your 250-word (or fewer) community service description is included with your application.
______ Your FAFSA Summary Sheet is included with your application.
______ Your 500 word (or fewer) essay is included with your application.
NOTE: The Filing Deadline for the MMPCIA Scholarship Application is June 15, 2016.
Submit complete application by Email to: [email protected] or mail to:
MMPCIA 2016 Scholarship Committee
P.O. Box 3270
New York, NY 10027
The Mount Morris Park Improvement Association Anti-Discrimination Policy:
In accordance with state, federal and municipal laws, the MMPCIA does not discriminate because
of race, disability, color, creed, religion, gender, age, sexual orientation, national origin, ancestry,
citizenship, military status or any other protected classification. This policy applies to all activities of
the MMPCIA, including but not limited to selection of volunteers, scholarship recipients, grantmaking, purchasing and selecting vendors or consultants.