Belt Public Schools

Due to BHS Counselor not later than May 1st at 4:00 PM.

On a separate page(s), please respond to the following 4 short answer (paragraph) questions and the essay question (I page double spaced). All applications will be typed. Late applications will not be accepted.

Attach this cover to your application materials. Please do not put your name on your answers to the questions.

(One paragraph recommended)

20% 1. Please explain your educational and career goals.

20% 2. Please discuss your participation in school and community activities or clubs and comment on your leadership contribution to these organizations. Include community service activities.

20% 3. Please state your need for financial assistance.

20% 4. Please comment on your academic achievements. List honors classes, AP classes, college classes, or other challenging academic pursuits.

20% ESSAY Questions: (please limit to 1 page, word processed, double spaced)

What positive contribution or impact have you left on one or more of the following? (School, Classmates, Faculty or Community)

Applicant Name: ________________________________________________________

Planned Field of Study: _______________________________________________________

Planned Institution of Attendance:

1st Choice __________________________________

2nd Choice __________________________________

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(For the school to complete)

Date of Graduation: __________________________________________________

GPA: ____________ Class Rank: ___________Class Size:______________

Date Application Received: _____________

__________________________________________________ _______

School Official Signature                                                                     Date