BEDFORD NORTH LAWRENCE SCHOLARSHIP FOUNDATION

SENIORS: IMPORTANT! SAVE FOR REFERENCE AND CHECKLIST

There are over 300 scholarships available through the Bedford North Lawrence Scholarship Foundation. Be
aware that some scholarships have specific requirements for students. The Scholarship Committee seriously
considers the criteria for each scholarship in selecting the recipients.

I. SCHOLARSHIP SELECTION PROCESS: (Students should keep a copy of their applications.)

APPLICATIONS:
• Applications MUST be turned in to the BNL Counseling Office by 3:00 pm, Friday, January 26.
Late applications will not be accepted. Be sure your application is complete before you turn it in.
Once it is turned in, it will not be returned. Notify the Foundation Office of any information that
changes.
• Include an appropriate wallet size head-shot picture. We no longer have access to the school’s
picture data base. You must provide the picture. It does not have to be a senior picture or one made
by a professional photographer. A snapshot is sufficient. Attach the photo to the original so it will be
on all the copies.
• Career Center applicants who do not attend BNL High School should have their high school attach a
copy of their grade transcripts, through seven semesters, to their application before the application
is turned in.
• If you are receiving an athletic scholarship from your college, check to see if under the NCAA
guidelines you may legally receive a scholarship from our Foundation.
• Make sure all requested information and material is included and the application is properly signed.
No incomplete application will be considered for a scholarship.

INTERVIEWS:
• A list of students selected to be interviewed will be posted outside of Miss Harrell’s classroom,
#3090 and in the BNL Counseling Office. Not all students who apply may receive an interview.
• Selected students will be interviewed by the Scholarship Selection Committee Tuesday March 20 –
Thursday March 22. Appropriate clothing is expected. An interview is part of the process but does
not guarantee a student will receive a scholarship.
• Students must have been accepted by an accredited vocational or technical school, or college by
the date of interviews with the Scholarship Selection Committee. If your first choice has not
responded by the application deadline, make sure you have been accepted by another school
before the interview date. Any student who has not been accepted by a college by the time of
the interview will not receive a scholarship.

STUDENT MEETING:
• A list of students selected to receive scholarships will be posted outside of Miss Harrell’s classroom,
#3090 and in the BNL Counseling Office. Not all students who were interviewed may receive a
scholarship.
• Students who have been selected to receive scholarships must pick up a notification letter from
Mrs. Byrer in the Counseling Dept. This letter contains information about the required student
meeting.
• Selected students must attend one of the pre-presentation meetings either before or after school,
April 11 or 12, where the procedure for the program will be explained.
• If you are receiving a 21st Century or other scholarships that will pay a large portion of your college
expenses, the amount you receive from our Foundation may be limited.
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II. PRESENTATION OF SCHOLARSHIPS AND AWARDS PROGRAM:

THURSDAY, April 26, 2018 - 6:30 pm,

BNLHS PERFORMING ARTS CENTER
• Recipients MUST be present at the BNLS Foundation Presentation of scholarships. The Foundation’s
Presentation of Scholarships and Awards Program is important to you and to the donors or their
representatives.

• A reception will be held following the program. Some donors will be there to meet you.

III. SIGNING OF CONTRACTS:

● Scholarship recipients bring ADDRESSED and STAMPED “Thank-You” notes for donors and sign
scholarship contracts - 11:00 am to 1:00 pm - BNL Performing Arts Center lobby.
● No contract may be signed until the thank-you notes are presented.
● No scholarship is finalized until the contracts are signed

IV. LOSS OF SCHOLARSHIPS:

• Failure to do any of the above items will result in the loss of scholarships.

• Failure to provide proof of enrollment in your chosen college will result in the loss of scholarships

SCHEDULE OF EVENTS FOR SCHOLARSHIP APPLICANTS

Friday, January 12, 2018 Applications available in the BNL counseling office, the Foundation office or
can be filled out on the Foundation website
http://bnlscholarshipfoundation.org printed and signed.

3:00 PM, Friday, Return of applications to BNL counseling office (ABSOLUTE DEADLINE).
January 26, 2018 The application must have an appropriate head-shot photo attached to
the applications.

March 20-22, 2018 Interview of selected applicants by Scholarship Selection Committee

Week of April 2 - 6, 2018 Notification of selection, pick up notification letter from Mrs. Byrer in the
Counseling Department.

April 11 & 12 You must attend a pre-presentation meeting either before or after school
when the presentation program will be explained.

Thursday, April 26, 2018 Foundation Presentation of Scholarship and Awards

Program - 6:30 pm, BNL Performing Arts Center.
Reception will follow program. (Attendance is mandatory)

Thursday, May 3, 2018 Recipients bring ADDRESSED and STAMPED “Thank-You” notes for
donors and sign contracts - 11:00 am to 1:00 pm - BNL Performing
Arts Center lobby

If you have questions or concerns regarding applications, please call Kim Gillespie in the Foundation Office at
812-279-3561 Ext. 48137, email [email protected] or come to the Office in room #137 in the Career
Center.
For upcoming information and dates
Visit our Facebook page - Bedford North Lawrence Scholarship Foundation

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 BEDFORD NORTH LAWRENCE SCHOLARSHIP FOUNDATION, INC.
SCHOLARSHIP APPLICATION

Date: ______________________________

1. Name of Student: ________________________________________________________________________________

Last First Middle
2. Home Address: __________________________________________________________________________________
(Street/P.O. Box) (City) (ZIP)

Phone #: _________________ Cell #__________________E-Mail Address: ____________________________________

3. Date of Birth: _______/_______/_______ SSN: _______/_______/_______ Sex: M______F______

4. College, Technical, Vocational School student will attend: ________________________________________________

(Name of College)

_________________________________________________________________________________________________
(School Address) (City) (State) (ZIP)

5. Preferred Major: (please specify) ____________________________________________________________________

6. Have you been accepted? _______ Date of Acceptance: ________________ University Student ID# ______________

7. Your Class Rank: _______________________ Number in Graduating Class: _______________ GPA: _____________
(Office use only) (Office use only) (Office use only)

8. Highest SAT/ACT Scores: M__________W__________CR__________Total____________ACT Scores____________

9. If you have had a significant illness or other situation that caused excessive absence or affected your GPA,
please explain: ___________________________________________________________________________
________________________________________________________________________________________
_______________________________________________________________________________________
(Attach extra sheet if needed)

10. Name of Parent or Guardian: (Please check the box for which parent is to be listed on the Scholarship Contract)
 Father: __________________________________________________________________________
Occupation: ___________________________ Employer: _________________________________
 Mother: __________________________________________________________________________
Occupation: ___________________________ Employer: _________________________________
If you have a legal guardian, Name of Guardian: ______________________________________

11. Number in your family, including your parents, now living in your home: ________
Number of children (excluding applicant) enrolled in college for the 2017-2018 school year: ________
Check the boxes that are true for you and follow the instructions:
 Your parents are both living.
 Your parents are living together.
 Your parents are divorced or separated.
 Your parent is widowed.
 Your parent is single.
 You are a ward of the Court.
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12.  Check this box if you are a 21st Century Scholar participant.
13. List extra-curricular activities (i.e.: school clubs, church, community service, drama, employment,
any volunteer work, etc.)
School clubs: _____________________________________________________________________________
________________________________________________________________________________________
Employment: _____________________________________________________________________________
________________________________________________________________________________________
Church activities: __________________________________________________________________________
________________________________________________________________________________________
Volunteer or community service: duties: # hours per week/month
______________________________ _________________________________ _______________
______________________________ _________________________________ _______________
(Attach extra sheet, if needed)

Please provide written confirmation from the community organization if you have a minimum of thirty (30)
volunteer hours in the twelve months preceding the application.

THE FOLLOWING INFORMATION WILL BE HELD IN COMPLETE CONFIDENCE

BY MEMBERS OF THE COMMITTEE
14. Total Family income as reported on your 2016 or most current available tax returns:
 $0 to $20,000  $21,000 to $40,000  $41,000 to $60,000 $61,000 to $80,000
 $81,000 to $100,000  $101,000+
15. Many of our scholarships are based on financial need. If you would like to be considered for these particular
scholarships, please provide the adjusted gross income from your most current available tax returns for all
persons responsible for student’s education.
Father_______________________ Mother__________________________
Joint_________________________ Guardian_________________________
Stepfather_____________________ Stepmother_______________________
Non-taxed income such as child support, etc.____________________________

16. If family finances have changed since your most current available tax returns, please explain: ____
________________________________________________________________________________________
17. What is your estimate of total expenses for the first year of college?
Tuition: $__________ Room/Board: $__________ Books/Fees $___________
18. Amount saved for college expenses by applicant: $_____________________
Amount saved for college expenses by your family: $____________________
19. From where do you expect to obtain additional assistance? ____________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
20. If you have already been notified of receipt of other scholarships, please list and give the amount of award:
_______________________________________________________________________________________
_______________________________________________________________________________________
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21. Some scholarships have specific requirements! Check the items that might be or are applicable to you.
 Member 4-H  Vocational  Agriculture  HOSA  BPA
 Member of the Future Farmers of America (at least 2 years)
 A relative is a member of Altrusa International, Incorporated of Bedford, Indiana
Name & Relation to applicant_____________________________________________________
 Attended BNL High School at least three years
 Attended Bedford Middle School _______years

 Attended Fayetteville School (K thru 5) _______years

 Attended Heltonville School (K thru 5) _______years

 Attended Lincoln School (K thru 5) _______years

 Attended Needmore School (K thru 5) _______years

 Attended Oolitic School (K thru 8) _______years

 Attended Parkview School (K thru 5) _______years

 Attended Shawswick School (1 thru 5) _______years (K-8) _______years

 Attended Springville School (K thru 5) _______years

 Attended Stalker Elementary School (K thru 5) _______years

 Attended St. Vincent de Paul School (Grades 1 thru 8) ______years

 BNL Baseball ______years ______years varsity

 BNL Basketball Team _____years ____years varsity
 BNL Football Team _____ years _____ years varsity

 BNL Golf Team _____years _____ years varsity

 BNL Soccer Team _____years _____years varsity

 BNL Track Team ______years _____years varsity

 BNL Volleyball _____years ______years varsity

 BNL Athlete (other than above)_____________________sport _____years _____ years varsity

 BNL Band ___________years

 BNL Choral Group ___________ Years

 BNL Orchestra Member ___________ Years

 BNL Student Council or Class/Club Officer (specify) ________________________________
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 BNL Youth Organization member
 Boys or Girls Club member (Past/Present) (Circle One)
 *Descendant - past or present Bedford Fire Department employee
Name & Relation to applicant: _____________________________________________________

 *Descendant - past or present Law Enforcement Officer

Name & Relation to applicant:______________________________________________________

 IU Health Bedford Hospital employee – parent

 IU Health Bedford Hospital Junior Auxiliary member
 St. Vincent Dunn Hospital - Candy Striper ___________years
 *Descendant of a Bedford High School Alumni (1936-1974) Year Graduated:_______________
Name (Maiden) Relation to applicant and Year Graduated: _______________________________

 *Descendant of a Heltonville High School graduate Year Graduated:_______________

Name (Maiden) Relation to applicant and Year Graduated: _______________________________

 *Descendant of a Needmore High School graduate Year Graduated:_______________

Name (Maiden) & Relation to applicant:_______________________________________________

 *Descendant of a Shawswick High School graduate Year Graduated:_______________

Name (Maiden) & Relation to applicant:______________________________________________

 *Descendant of a Times Mail Employee

Name (Maiden) & Relation to applicant:______________________________________________

 *Child of a current employee at Architectural Stone Company

Name (Maiden) & Relation to applicant:______________________________________________

 Descendant of a member of the Knights of Columbus Council 1166

Name (Maiden) & Relationship to applicant: __________________________________________

 Church Attending_____________________________________________ # years____________

 Descendant of a veteran - (you are the) child, grandchild – Please attach a copy of the veterans DD214
Mark which of the following apply:

 honorably discharged * Name_________________________________________________________

 combat-wounded veteran awarded the Purple Heart *Name__________________________________
 was a Prisoner of War * Name_________________________________________________________
 Disabled veteran * Name_________________________________________________________
Relationship & War (be specific): _____________________________________________________________

 Descendant of a member of the Bedford Boat Club

Name (Maiden) & Relationship to applicant: __________________________________________

 Parent is a Member of Hoosier Hills Credit Union

(Students whose parents are employees/volunteers of Hoosier Hills Credit Union are NOT eligible)

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  Member of National Honor Society (Current)
 Member of Fellowship of Christian Athletes
 North Lawrence Education Association member – parent, grandparent or step-parent
 Resides in Indian Creek Township (4 or more years)
 Resides in the Bedford Enterprise Zone
 Latin Class (Please check appropriate years)
Freshman______ Sophomore______ Junior______ Senior______

 North Lawrence Career Center Health Occupations Class (Please check appropriate year)
Junior Year _______ Senior Year _______

 North Lawrence Career Center Building Trades (Please check appropriate year)
Junior Year _______ Senior Year _______

 Other North Lawrence Career Center Classes (Please indicate class and check appropriate year)
Class __________________________ Freshman ___ Sophomore ___ Jr year ___ Sr year ___
Class __________________________ Freshman ___ Sophomore ___ Jr year ___ Sr year ___
By signing us:
1) Hereby authorize Bedford North Lawrence High School to attach a copy of this applicant’s transcript, and
Provide information in the student’s personal record file to the BNL Scholarship Foundation.
2) Certify the correctness of the information on the application
3) Give the Foundation permission to use our applicant’s picture, name, and scholarships received for promotional
purposes in the local newspaper and other media
4) Agree to abide by the conditions set out in the Scholarship Contract to be signed on receipt of a scholarship

____________________________________ ______________________________________
Parent email address Printed name of Parent or Guardian

Note: Please tape an appropriate wallet size head-shot ______________________________________________

photo to the original application only. Signature of Parent or Guardian
**This will be used in the newspaper.

Attach
photo
here

(If picture is not appropriate, it will be replaced with a previous yearbook picture)
*After completion of application, please submit original & seven copies to BNL Counselor’s Office.
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