ࡱ> RTQ bjbj99 4L[{_[{_ $yz^????. :$"pBBB??3Bj??BpPpqI0y#p##DBBBBBBBpBBByBBBB#BBBBBBBBB : USF College of Behavioral & Community Sciences Department of Child and Family Studies 2023 Clinical Rehabilitation and Mental Health Counseling Scholarship Application Please check the scholarships for which you are applying. You may apply for one or all three.  FORMCHECKBOX  Susan D. Kelley CRMHC Textbook Scholarship (double click on the box to check)  FORMCHECKBOX  Calvin M. Pinkard Scholarship (double click on the box to check)  FORMCHECKBOX  Lynn Bartolotta Scholarship (double click on the box to check)  FORMCHECKBOX  Dae Sheridan Scholarship (double click on the box to check) Please submit the following information and include all of the items in Sections II - V below. 1. STUDENT INFORMATION First Name: Last Name: Student ID (U#): Email address: Local Mailing Address: City, State, Zip: How many credit hours have you successfully completed thus far in the CRMHC Masters program (do not include the classes in which you are currently enrolled)? Current GPA in the CRMHC Masters program: Have you ever been on academic probation in the CRMHC Masters program? (double click on the box to check)  FORMCHECKBOX  No  FORMCHECKBOX  Yes, On what date did you return to good standing? ___________________________ II. ESSAYS (Each scholarship requires its own essay. Please label appropriately) A. Susan D. Kelley Textbook Scholarship. These awards are based on financial need. Please write a 500 word essay describing the rationale for your request for a need-based scholarship. (Note: these essays will be read by the CRMHC Scholarship Committee. They may also be shared with the other CRMHC core faculty members, but no one else will see what you have written.) B. Calvin M. Pinkard Scholarship. Please write a 500 word essay stating how you intend to use the funds, and specific ways in which you commit to using your degree to benefit others and your community. (Note: these essays will be read by the CRMHC Scholarship Committee. They may also be shared with the other CRMHC core faculty members, but no one else will see what you have written.) C. Lynn Bartolotta Scholarship. This award will support a student who is experiencing significant financial need and who intends to serve people who are typically considered underserved. Please write a 500 word essay describing your financial situation, career goals, and the specific ways in which in which you commit to using the scholarship to serve people who are typically considered underserved. (Note: these essays will be read by the CRMHC Scholarship Committee. They may also be shared with the other CRMHC core faculty members, but no one else will see what you have written.) D. Dae Sheridan Endowed Scholarship. This scholarship provides $1000 to two students each year. Preference is given to first-generation CRMHC students who have demonstrated an intent to improve the fields of mental health counseling and human sexuality education. Please write a 500 word essay documenting whether you are a first generation college student, and describing how you plan to both improve the field of mental health counseling and further human sexuality education. (Note: these essays will be read by the CRMHC Scholarship Committee. They may also be shared with the other CRMHC core faculty members, but no one else will see what you have written.) III. School Activities, Community Involvement, Leadership Please provide a list of any academic honors, extracurricular activities, leadership activities, community service, research activities, etc. IV. Please include your CURRICULUM VITA or RSUM with your application. V. STUDENT CERTIFICATION Please note that scholarship awards may impact the amount and level of funding you receive from other sources of financial aid administered by the University. All application materials must be submitted by 11:59 pm on _4/23/2023 . By signing this application, you give permission to the CRMHC faculty and staff involved in the scholarship award process to view your student records in order to verify your application. I certify that the statements contained in this application are true and complete. I understand that fraudulent information will result in disqualification and other academic penalties. I hereby allow my educational information (including GPA and number of hours) to be confirmed in OASIS/Banner. ________________________________________ ________________ Signature Date Completed Application Packet should be submitted by email to Dr. Rick Weinberg at  HYPERLINK "mailto:weinberg@usf.edu" weinberg@usf.edu on or before 5pm on 4/23/2023. Please put CRMHC Scholarship Application in the email Subject line. 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