2016 SCHOLARSHIP APPLICATION APPLICATIONS MUST BE POSTMARKED BY MARCH 1, 2016

(1)

Page 1 of 7

2016 SCHOLARSHIP APPLICATION

APPLICATIONS MUST BE POSTMARKED BY MARCH 1, 2016

The Texas Trucking Association (TXTA) Foundation is a non-profit educational, public relations, research and community service organization created by the TXTA to promote the trucking industry to the people of Texas. TXTA represents more than 800 carriers and allied companies operating in Texas.

Drivers, dock workers, mechanics and office personnel are among the thousands of people who contribute to a strong, efficient motor transportation industry in Texas. Many of these workers are, or have dependents, pursuing degrees in higher education or trade schools. The TXTA Foundation would like to help these students in their efforts by providing scholarships to TXTA company member employees, dependents and/or grandchildren. Scholarship recipients will be selected on the basis of their academic achievement, community involvement and financial need. The Foundation will provide financial assistance for university, college and trade school students. Scholarships may be used to meet such expenses as tuition, books and housing.

SELECTION AND NOTIFICATION

The Board of Trustees is comprised of 15 members. Scholarship recipients are chosen by the Board of Trustees of the TXTA Foundation in May. By submission of this application, the applicant acknowledges that the decision to award a scholarship, the amount of any scholarship awarded and the criteria used to make such decisions is within the sole and absolute discretion of the trustees of the TXTA Foundation.

Scholarship funds are mailed directly to the school listed on the application in July after verification of full-time enrollment. Funds are divided equally between the fall and spring semester of the awarded year. Each applicant will receive a notification letter by May 30. Please refrain from calling the Foundation for status updates. Calls after June 6 are welcome if a notification letter has not been received.

RECIPIENTS AWARDED SCHOLARSHIPS

We are interested in your academic and professional success. The Foundation requests updates from students after each semester and an update as graduation from your school of higher education nears. Please mail updates to the TXTA Foundation scholarship committee at 700 East

11th_{Street, Austin, TX 78701, or e-mail to [email protected].}

ELIGIBILITY

● TXTA carrier or allied member

employee, dependent and/or

grandchild

● High school senior, graduate or

equivalent

● Full-time enrollment at an

institution for higher education (12

hours/semester)

*Previous scholarship recipients may

apply if he/she continues to meet

above eligibility standards

REQUIREMENTS

Applications must be postmarked

by March 1, 2016 and include the

following:

Completed application

Recent professional photo

(scanned copies not acceptable)

Copy of most recent or year-end

transcript

One to three letters of

recommendation from a

non-familial source

Personal narrative

(750 words or fewer)

________________________ Applications should be submitted to:

(2)

Page 2 of 7

STUDENT INFORMATION

NAME:

________________________________________________________________________________________

(Last) (First) (M.I.) (Preferred Name)

ADDRESS: ______________________________________________________________________________

________________________________________________________________________________

(City) (State) (ZIP)

PHONE: _ E-MAIL: _______________________

DOB: __/_/_____ SSN: _-_- GENDER: ____

HIGH SCHOOL:

___________________________________

GRADUATION DATE: //___

Please check if currently enrolled

INTENDED COLLEGE/UNIVERSITY/TRADE SCHOOL: _________________________________________

(If undecided, please include all schools in consideration.) Please check if currently enrolled

CUMULATIVE GPA:

_____

on 4.0 scale 5.0 scale 6.0 scale (Use most recent GPA)

ACT SCORE

: _ SAT SCORE: _

INTENDED MAJOR(S)/AREA(S) OF STUDY: ___________________________________________________

AS OF AUGUST 2016,

YOUR STATUS WILL BE:

Freshman Sophomore

Junior Senior

Other: _________________________________________

MARITAL STATUS:

Single Married Number of Dependents: ___________

EMPLOYER:

________ TITLE: _

SUPERVISOR: ______________________________ SUPERVISOR PHONE:

___________________

HOBBIES/INTERESTS: ____________________________________________________________________

ACTIVITIES, AWARDS, VOLUNTEER SERVICE AND HONORS:

(Please only include those within the last four years. Do NOT attach additional pages.)

(3)

Page 3 of 7

FAMILY INFORMATION

AFFILIATION WITH THE TRUCKING INDUSTRY:

Self Spouse

Parent/Guardian Grandparent

Name of Relative: ____________________________________________________________ Member Company: ___________________________________________________________

SPOUSE

(Please complete if married/widowed)

NAME: _______________________________________________________ LIVING?:

Yes No

EMPLOYER: _________ TITLE: _

SUPERVISOR: ___________________________________________________________________________

SUPERVISOR TITLE: ____________________ PHONE: _

PARENT/GUARDIAN

(Please complete if a dependent)

FATHER/GUARDIAN NAME: _____________________________________ LIVING?:

Yes No

EMPLOYER: _________ TITLE: _

SUPERVISOR: ___________________________________________________________________________

SUPERVISOR TITLE: ____________________ PHONE: _

MOTHER/GUARDIAN NAME: _____________________________________ LIVING?:

Yes No

EMPLOYER: _________ TITLE: _

SUPERVISOR: ___________________________________________________________________________

SUPERVISOR TITLE: ____________________ PHONE: _

PERMANENT RESIDENCE:

I live at home with my parents I live in a single family household with my __________________________ Other (Please explain if you live with a guardian, grandparent or have other arrangements)

___________________________________________________________________________________ If you checked Single Family Household or Other, please complete the following:

Does the non-resident parent contribute to your support? Yes No If yes, amount per year: ________________

Comments: _________________________________________________________________________

During your college career, will any of your siblings also be enrolled in college? Yes No

(4)

Page 4 of 7

FINANCIAL INFORMATION

COLLEGE/UNIVERSITY/TRADE SCHOOL INFORMATION FOR FALL 2016 SEMESTER

(If undecided, please include information for all schools in consideration.)

INSTITUTION NAME: ______________________________________________________________________

ESTIMATED TUITION/SEMESTER: _$__________________

#CREDIT HOURS/SEMESTER: _________

(Do NOT include books, room/board, etc.) (Must be enrolled full time—minimum 12 hours)

ANTICIPATED FINANCIAL SUPPORT PER SEMESTER: $ ________________________

(From parents, relatives or other non-scholarship, non-loan sources)

OTHER SCHOLARSHIPS/LOANS FOR WHICH YOU HAVE APPLIED

If you are applying for other scholarships or loans, please list them below. Indicate the status as pending, confirmed or rejected. If pending, please provide the anticipated confirmation date. You may be contacted at a later date to verify approval/denial for any of the below. For scholarships, please include any application you have filled out to be considered for money to be used for any educational expenses. You must provide the total monetary amount of scholarship—do NOT put “depends” or “varies.” Loans refers to any money that you have applied for or have been given with the intent to pay back. This money could be from a commercial lender, family members or other persons/businesses.

ARE YOU A PREVIOUS TXTA SCHOLARSHIP RECIPIENT?

Yes No Year(s): _______________

ANNUAL HOUSEHOLD INCOME INFORMATION

We rely on the integrity of your character to report this information fully and accurately.

Your family’s adjusted gross income may be found on (or around) line 34 of the most recent U.S. Individual Federal Income Tax Form 1040. Failure to complete this section will result in the loss of any points available for this position of financial need evaluation. All income may be subject to verification through request of annual Internal Revenue Service returns.

TOTAL HOUSEHOLD INCOME FOR 2014 TAX YEAR:

This includes your annual salary, your spouse (if applicable) and legal guardian(s).

< $25,000 $25,000-$50,000

$50,000-$100,000 $100,000-$150,000 $150,000+

SCHOLARSHIP $/YEAR # YEARS TOTAL AMOUNT STATUS CONFIRMATIO N DATE

(5)

Page 5 of 7

PERSONAL NARRATIVE

(6)

SIGNATURE

By submission of this application, I, the applicant, acknowledges that the decision to award a scholarship, the amount of any scholarship awarded and the criteria used to the make such decisions is within the sole and absolute discretion of the trustees of the TXTA Foundation. I, the undersigned, declare that the information provided on this application is accurate and truthful, and understand the TXTA Foundation criteria (high school graduate or equivalent; employee of, grandchild of or a dependent of a TXTA member company in good standing; enrolled as a full-time student). I understand that false statements shall be cause for immediate disqualification of scholarship consideration.

______________________________________________ ________________________

Applicant Signature Date

CHECKLIST

Before submitting your application, please ensure you have included the following:

Completed application

Official transcript(s)

One to three letters of recommendation from non-familial source

Recommendation Letter 1 Name: ___________________________________________________ Company/Employer: _________________________________________ Job Title: _________________________________________________ Relationship to Applicant: _____________________________________ Recommendation Letter 2 Name: ___________________________________________________ Company/Employer: _________________________________________ Job Title: _________________________________________________ Relationship to Applicant: _____________________________________ Recommendation Letter 3 Name: ___________________________________________________ Company/Employer: _________________________________________ Job Title: _________________________________________________ Relationship to Applicant: _____________________________________

Recent professional photograph—no scanned photocopies

Do NOT include additional attachments

(i.e. resume, extra pages for “Activities, Awards,

Volunteer Service and Honors” or “Personal Narrative” sections)

.

INCOMPLETE SUBMISSIONS OR THOSE POSTMARKED AFTER MARCH 1, 2016 WILL RESULT IN IMMEDIATE DISQUALIFICATION.

APPLICATION SUBMISSION

E-mail to: [email protected]

Or mail to: TXTA Foundation, Attn: Scholarships, 700 E. 11

th

_{Street Austin, TX 78701}

Questions? Call 800.727.7135 x 104

(7)

2016 SCHOLARSHIP APPLICATION APPLICATIONS MUST BE POSTMARKED BY MARCH 1, 2016