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$1,500 Honor Service Award Available to a Student or Alumni of a County within the Keystone SMILES network – see regional map below. $1,250 Silver Service Award Available to a Student or Alumni of a Clarion County Public or Private School Name of Clarion County School: ____________________________________
$750 Bronze Service Award Available only to Student or Alum of: Clarion Career Center Keystone High School Keystone SMILES Alternative Education Program
Applications must be submitted online and certifications post marked no later than May 31st
Send Certification Page to: Ross McGinnis Memorial Service Award Keystone SMILES P O Box 352 Knox, PA 16232
PFC Ross McGinnis Memorial Service Award Instructions
These Memorial Awards recognize young leaders who
have demonstrated outstanding humanitarian
efforts and citizenry activities while serving their community, school, church,
and country.
Keystone SMILES Inc. www.smilesamericorps.org
Memorial Service Awards to be
announced on June 14th
2
Service Making an Impact through Learning Experiences with Students
Copyright 2006 Keystone SMILES, Inc., 10/4/2011
www.smilesamericorps.org
Application Instructions
1. Review Eligibility requirements 2. Completed ONLINE Application found at https://www.keystonesmiles.org/Memorial_Award.htm
Or directly at https://keystonesmiles.wufoo.com/forms/z19pn74c0riipqr/ a. Complete all items on checklist detailed on certification page in this document b. Upload all required items
3. Print and complete certification page (page 3 of this document) and send to Keystone SMILES at PO Box 352; Knox, PA 16232
ELIGIBILITY/ APPLICANT REQUIREMENTS
Must demonstrate participation in an outstanding service project or activity addressing human needs, environment, public safety or education which benefited an individual or group. (AmeriCorps service hours do not count toward this award)
The Honor “Service” Award - must have attended or currently attends a high school or post-secondary school located in a county identified on the regional map. (Refer to map illustration.)
The Silver “Service” Award - must have attended or currently attend a Clarion County Public or Private School and be enrolled in a post-secondary technical / career / educational institution to access the award.
The Bronze “Service” Award – must have attended or currently attends Keystone High School, Clarion Career Center or Keystone SMILES Alternative Education Program and be enrolled in a post-secondary technical / career / educational institution to access the award.
Has not been a recipient of this Award previously. This is a one-time award.
Must have a minimum of 2.75 GPA at time of application and Award disbursement.
Must be a U.S. citizen or permanent resident.
Applicant agrees to be present at the annual Award Ceremony to be held at the Keystone SMILES Community Learning Center in Knox, PA.
AWARD INFORMATION
The Honor “Service” Award will be in the amount of $1,500. Eligible applicants must be a current student or alumnus of a school within a county identified on the regional eligibility map.
Award will be released only to the post-secondary school the recipient is attending. Funds will be released after recipient completes one school year of post-secondary education with a GPA of 2.75 or higher.
The Silver “Service” Award will be in the amount of $1,250. Eligible applicants must be a current student or alumnus of a Clarion County school.
Award will be released only to the post-secondary school the recipient is attending. Funds will be released after recipient completes one school year of post-secondary education with a GPA of 2.75 or higher.
The Bronze “Service” Award will be in the amount of $750. Eligible applicants must be enrolled or be an alumnus of Keystone High School, Clarion County Career Center, or Keystone SMILES Alternative Education Program.
Award will be released only to the post-secondary school the recipient is attending. Funds will be released after recipient completes one school year of post-secondary education with a GPA of 2.75 or higher.
3
Service Making an Impact through Learning Experiences with Students
Copyright 2006 Keystone SMILES, Inc., 10/4/2011
www.smilesamericorps.org
CERTIFICATION PAGE To be signed and mailed in as to complete the application process
Applicant Name _ _________________________________________________ Have you ever served as an AmeriCorps member? _____ YES _____ NO
Initial all appropriate award(s) that you are applying for:
_____$1,500 Honor Service Award Available to a Student or Alumni of a County within the Keystone SMILES network –see regional map below. _____$1,250 Silver Service Award Available to a Student or Alumni of a Clarion County Public or Private School
Name of Clarion County School: ____________________________________
_____ $750 Bronze Service Award – Only available to students or alumni of: (check one)
____Clarion Career Center ____Keystone High School ____Keystone SMILES Alternative Education Program
CERTIFICATION
I (applicant name) verify the enclosed information submitted with this application is true and is accurately documented. Applicant Signature ____________________________________________________ Date: _____ /_____ /______ If 17 years of age or younger, parent signature is required:
Parent or Guardian Signature_____________________________________ Date:_____/____/_____
Parent Information Contact Phone Number: ______________________ email address: ____________________________________
Please
Required online and printed Paperwork
Completed ONLINE Application found at https://www.keystonesmiles.org Or directly at https://keystonesmiles.wufoo.com/forms/z19pn74c0riipqr/ Includes a 500-1000 word Essay of Outstanding Service (online application-Page 4)
Completed Resume (uploaded as attachment to online application) – example in these instructions
Service Reference Letter (uploaded as attachment to online application
Character Reference Letter (uploaded as attachment to online application
Documentation of High School Attendance and GPA (High School Diploma and either High school / College Transcripts) (uploaded as attachment to online application
Picture for Media Release (uploaded as attachment to online application
This Certification page signed and mailed to Keystone SMILES at PO Box 352; Knox, PA 16232
4
Service Making an Impact through Learning Experiences with Students
Copyright 2006 Keystone SMILES, Inc., 10/4/2011
www.smilesamericorps.org
Julieta Jones 1234 Roman Drive, Knox PA 16232
814-797-1111 - [email protected] Education Year(S)
Gannon University , Erie PA 2004-present Business Administration Minor - Marketing Clear Creek High School, Clarion County 1999-2004 General Studies - QPA 2.90 Immaculate Conception Elementary School 1991-1999 Kindergarten-eight grade
Memberships in clubs, organizations and sports Year (s)
President Student Council 2001-2002
4-H Club member 1995 – 2004
Clear Creek High School – Basketball Team 1999-2003
Rising Stars AAU Coach - 7th grade 1997-1998
Awards/recognition Year (s)
Keystone SMILES Charity Challenge President Youth Scholarship Award 2004 Volunteered 300 hours of community Service 2004
4 -H Outstanding Youth Volunteer Award 2003
Service EXPERIENCE – Includes Volunteer, National, or Military Year (s)
Youth Field Day Volunteer 2005-Present Sunday School Bible School Aide 2001-2004
Service Volunteer Serve in a summer youth corps program mentoring youth ages 10-14
1995 - 1999
Work Experience Year (s)
Wal-Mart Cashier 2003-present Customer service, cashier-summer Clarion PA Katie’s Ice Cream Shop 1999-2000 Strattanville, PA
Use this resume format when creating your resume as part
of your application.