Chamber Hoskins Application 2012.pdf

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________________________ ______________________________________________Date Applicant's name

SCHOLARSHIP PROGRAM2011-2012 Scholastic Year

APPLICATION FORM

BILL & LOUISE HOSKINS $1,000.00 VISUAL ART SCHOLARSHIP PROGRAMScholarship provided by the Greater Palm Harbor Area Chamber of Commerce Foundation, Inc. from proceeds of the

Palm Harbor Arts, Crafts & Music Festival.Recipient selected by the independent Art Scholarship Committee

CRITERIA1. Graduating Senior2. Resident of the Greater Palm Harbor Area.

Zips Codes: 34681, 34683, 34684, 34685and 34660, 34688*, 34677* (*unincorporatedareas only)

3. Acceptance to an art school or college tostudy the visual arts.

To Apply: Complete this form in its entirety andsubmit it with the following support material:

1. Cover letter stating your aspirations and / or

intentions.2. Three {3} Letters of Recommendation {none

from a relative}, one covering each of thefollowing areas: Artistic ability, Extra-curricular school art activities, andCommunity and / or artistic involvement.

3. A. Submit four {4} slides or photographs, excellent quality, representative of your beartistic works. All work must be original worcreated solely by the applicant. (Poor qualslides/photographs may not afford the Committean accurate evaluation of the artists style). Slidand/or photographs submitted cannot be returneNote: Please do not submit original artwork.B. Each slide or photograph must be markedwith your name and phone number and must bemarked with an arrow to indicate the top.C. Slides must be 2 x 2 or 35mm and must nbe taped together. Photographs smaller than 35 will not be considered.D. Photographs may be emailed [email protected]

The application form, cover letter, three letters of recommendation and support materials must be postmarked on orbefore April 20, 2012. Mail to: Palm Harbor Chamber of Commerce, 1151 Nebraska Ave., Palm Harbor, FL 34683

Attn: Visual Art Scholarship CommitteeIf you have any questions, please call the Chamber at (727) 784-4287

GREATER PALM HARBOR AREA CHAMBER OF COMMERCE FOUNDATION, INC.

Name ___________________________________________________________________________

S. S. # ___________________________________________________________________________

Parent/Guardian __________________________________________________________________

Address __________________________________________________________________________

Telephone ___________________________ Date of Birth ________________ Female/Male_______

Proposed Graduation Date ____________________________________________________________

School _________________________________ Date Enrolled ________________________________

School _________________________________ Date Enrolled ________________________________

Career Goal _______________________________________________________________________

Grade Point Average {Cumulative - 11th & 12th grade} ______________________________________

Intended Educational Facility _________________________________________________________

Are you a legal resident of the United States? Yes____ No____

(Please see reverse side) rev. 3/12

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List Name, Address and Phone Number of persons submitting Letters of Recommendation

1. _______________________________________________________________________________

2. _______________________________________________________________________________

3. _______________________________________________________________________________

VISUAL ARTISTIC ACHIEVEMENTS /AWARDS/RECOGNITION

__________________________________ __________________________________________ _____Achievement Award/Recognition Organization month/year



SCHOOL RELATED ACTIVITIES

__________________________________ _________________________________________________Office / Position Organization month/year

__________________________________ _________________________________________________

Office / Position Organization month/year __________________________________ _________________________________________________Office / Position Organization month/year

__________________________________ _________________________________________________Office / Position Organization month/year

COMMUNITY / BUSINESS / CHURCH / OTHER ACTIVITIES ____________________________________ _____________________________________

Artistic Service Organization month/year ____________________________________ _____________________________________

Artistic Service Organization month/year ____________________________________ _____________________________________

Artistic Service Organization month/year

____________________________________ _____________________________________Artistic Service Organization month/year

PAST/ PRESENT EMPLOYMENT

______________________________________ ________________ ________________Business or Organization Dates {to-from} Supervisor

_____________________________________ ________________ ________________Business or Organization Dates {to-from} Supervisor

____________________________________ ________________ ________________Business or Organization Dates {to-from} Supervisor

If you wish to provide additional information, use the space below or attach a separate sheet.___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

Briefly stated, what is your understanding of the Visual Arts in our

Community?______________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

Chamber Hoskins Application 2012.pdf

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