Northland Scholarship Services - Duluth, Minnesota Northland Scholarship Services - Duluth, Minnesota




Greater Denfeld, Hauge, IKONICS and Saltwick
Scholarship Application

Online applications must be completed in one sitting; you cannot fill out part of the form, save it and fill out the remainder later.

Additional paperwork (transcripts, letters of recommendation and, in some cases, financial documentation) may be required. Instructions and a checklist of requirements will be displayed after you complete and submit the online application. Be sure to print or save those instructions and submit the required documents to complete the application process.

CHECK THE SCHOLARSHIP(S) FOR WHICH YOU ARE APPLYING:

Marie V. Saltwick
Greater Denfeld Scholarships
Hauge Scholarship
IKONICS Scholarship


First Name:
Middle Initial:
Last Name:
Address:
Address 2:
City:
State: Zip:
Phone:
Email:
High School:
Graduation Year:
Indicate the colleges you are considering:
Present major field of interest:
Course length: years.
Why have you chosen this field?
Age:
Date of Birth:
Place of birth:

Parent / Legal Guardian

First Name:
Last Name:
Occupation:
Same address as above? Yes
If yes, you may skip the following address section.
Address:
Address 2:
City:
State: Zip:

Parent / Legal Guardian
First Name:
Last Name:
Occupation:
Same address as above? Yes
If yes, you may skip the following address section.
Address:
Address 2:
City:
State: Zip:

List Children in Family and Ages:

Name and email address of teacher(s) or counselor from whom you have requested references:


If you have had employment, please list:
EMPLOYER TYPE OF WORK DATES HOURS PER WEEK


Indicate all school activities and/or organizations and year(s) in which you are now or have been an active participant. Indicate leadership position if you have been an officer, captain, etc.

Student Government
9 10 11 12 Officer

Student Council
9 10 11 12 Officer

Class Officer
9 10 11 12

National Honor Society
9 10 11 12 Officer

Service Organization
9 10 11 12 Officer

Green Club
9 10 11 12 Officer

Key Club
9 10 11 12 Officer

Diversity Team
9 10 11 12 Officer

AFS
9 10 11 12

Debate
9 10 11 12 Captain

Speech
9 10 11 12 Captain

Band
9 10 11 12 Sec. Leader

Ensemble Group
9 10 11 12

Orchestra
9 10 11 12 Sec. Leader

Ensemble Group
9 10 11 12

Choir
9 10 11 12 Sec. Leader

Ensemble Group
9 10 11 12

Drama
9 10 11 12 Director

Musical
9 10 11 12 Director

Improv. Group
9 10 11 12

School Newspaper
9 10 11 12 Editor

Year Book
9 10 11 12 Editor

Literary Magazine
9 10 11 12 Editor

Math Team
9 10 11 12 Captain

Music Listening
9 10 11 12 Captain

Knowledge Bowl
9 10 11 12 Captain

Mock Trial
9 10 11 12

Peer Helper/Mediator/Tutor
9 10 11 12

School Spirit Committee
9 10 11 12

Scholastic Club
9 10 11 12

Prom Committee
9 10 11 12

Junior Rotarian
9 10 11 12

HOSA
9 10 11 12 Leadership

Varsity Sports:
Fall
9 10 11 12 Captain

Winter
9 10 11 12 Captain

Spring
9 10 11 12 Captain

Clubs and Activities for which you are NOT receiving credit:
Fall
9 10 11 12 Captain

Winter
9 10 11 12 Captain

Spring
9 10 11 12 Captain

Other:
9 10 11 12


9 10 11 12


9 10 11 12


9 10 11 12


List community activities (church, Scouts, 4-H, theater, music, sports, volunteer work).

Organization Dates of Participation Offices Held

List all honors, prizes or special recognitions you have received during grades 9 through 12 with dates awarded. (Be sure to include any academic honors.)

Organization
(school, church, community or national)
Honor Date

From your classroom or extra-curricular activities, in or out of school, please explain (in 250 words or less) what were your accomplishments in which you took pride? If you have extenuating circumstances that prevented you from participating in extracurricular activities, please explain (in 250 words or less).

Describe how you have demonstrated leadership or responsibility either within or outside of school in 250 words or less.

Name three courses from your high school years which you feel have best prepared you for college or your chosen major and why.
Course 1: (in 100 words or less)

Course 2: (in 100 words or less)

Course 3: (in 100 words or less)

Everyone has had life experiences that have had a profound effect on them. In 350 500 words, describe a challenge or setback that you have faced while working towards reaching a goal. What did you learn from it and/or about yourself that will help you in the future?

Saltwick Applicants: An important consideration of the Marie V. Saltwick Scholarship is good character. Write an essay of up to 250 words describing what good character means to you and why your good character makes you deserving of this scholarship.

Hauge Applicants: Hard work is an important consideration for the Armond Hauge Scholarship. Write an essay of up to 250 words detailing how you have demonstrated hard work during your high school career.

Tessier/Waltman Scholarship: Applicants for the Tessier/Waltman list sports in which you have been awarded a letter.

Statement of Authorization, Accuracy and Release
All the information above constitutes my application for the Northland Scholarship Services Scholarships, and is correct and true to the best of my knowledge and belief. If awarded a Scholarship, I agree to abide by all its requirements. As the applicant, I understand that all information will be furnished to the Committee, and shall be confidential.

If I am awarded a scholarship, I also agree to give the Northland Scholarship Services permission to publish my name as a recipient.

I AGREE and accept these terms
I DO NOT agree and accept these terms

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