Scholarship Application - The Friendship Journey

Jaime Guttenberg & Gina Montalto Friendship Scholarship

Application deadline: May 15, 2020

The Jaime Guttenberg & Gina Montalto Friendship Scholarship

Inclusive Scholarship Application

*If the applicant needs assistance to complete this application, they may seek assistance from their parent or guardian. This assistance should be discussed with a TFJ representative, prior to completing the application to make sure the modification provides an equitable opportunity to all applicants. For accommodations, please email: hello@thefriendshipjourney.org detailing assistance that is needed.

Eligibility

Committed to embodying the values of inclusivity, kindness & empathy within their communities & beyond
Graduating senior or student
A minimum of eighty cumulative hours as a volunteer or participant with The Friendship Journey.
Accepted for full-time enrollment at a college, community college, university, trade school, institute of technology, seminary, vocational rehabilitation or other approved program.
Minimum cumulative grade point average (GPA) of 2.75 (based on 4-point scale). If specific accommodations or considerations to be made for a GPA lower than 2.75, please include detailed explanation.

Award Amount

The annual scholarships awarded will be determined by the Scholarship Committee based on the applicant’s commitment to service and availability of funds each year. Individual scholarship awards will not exceed $4,000.

Tax Information

No services are required from you if you receive a scholarship, so the amount awarded is not required to be reported by The Friendship Journey on any form to the IRS. However, the scholarship must be spent on “qualified educational expenses” (tuition, course supplies) to remain tax free. Tax topic 421 at irs.gov (https://www.irs.gov/taxtopics/tc421) contains additional information about qualified expenses.

Scholarship Application Form

If you are human, leave this field blank.

TELL US ABOUT YOURSELF

Please provide information about yourself. *If this application is being completed by a parent, guardian or other on behalf of the applicant, please include the name of person completing form and applicant’s involvement in addition to the applicant’s information.

Last Name *

First Name *

Date of Birth *

Address *

Address

City

State/Province

Zip/Postal

Phone *

Email *

Name of Person Completing Application (if not self)

If applicable please describe the applicant’s involvement in completing this process (e.g., Provided answers verbally, communicated using augmentative & alternative communication, used gestures, implemented visuals etc.):

Please contact: hello@thefriendshipjourney.org for any accommodations.

PARENT(S)/GUARDIAN

Please provide information about your parent(s) or guardian with whom you reside if you are under the age of 18.

Last name

First Name

Address

City

State/Province

Zip/Postal

Phone

Email *

Relationship to Student

i.e., Mother & Father, One parent only, Aunt, Grandparent, etc.

HIGH SCHOOL (For High School Seniors)

Please provide information about the high school that you are currently attending.

High School Name

City

State

Zip

Phone

GPA

Anticipated Date of Graduation

Additional considerations/accommodations

WHAT'S NEXT?

Please provide information about the college, community college, university, trade school, institute of technology, seminary, vocational rehabilitation or other approved program that you will be attending or in which you are currently enrolled.

Name

Phone

City

State

Zip

Start Date

Anticipated Graduation Date

Field of Study

If pursuing vocational opportunities, employment or other program, please include the name and your role

TELL US MORE

How long have been involved with the Friendship Journey

Please share all programs, experiences, events and/or leadership roles you have been part of with The Friendship Journey

Jaime & Gina were passionate & generous individuals who believed in giving back to their community. Please share any public service and community activities you have been involved with during your high school career. Include your type of involvement, how long you have been involved and anything else you would like us to know about this involvement. Please include your service with The Friendship Journey and any other school, religious, philanthropic, or leadership organization.

What are your plans after high school? How will you continue to implement the values of kindness, inclusion, empathy & compassion that were important to Jaime & Gina?

Tell us your favorite memory with The Friendship Journey.

SHORT ESSAY

The Friendship Journey’s motto is “Share the Path With a Friend.” How will you continue to share your journey with your friends of all abilities beyond high school? How has your experience with The Friendship Journey shaped your perspective? Please limit your response to 800 words.

CERTIFICATION AND SIGNATURE

I hereby certify and swear that all of the information on this form is true and complete to the best of my knowledge. If asked by an authorized official of The Friendship Initiative, Inc d/b/a The Friendship Journey, I agree to give proof of the information that I have given on this form. Falsification of information may result in termination of any scholarship granted and required repayment of any award paid on behalf of the applicant. It is understood that this application becomes the property of the Friendship Journey.

Applicant's Signature *

Typing your name above will be your signature

Date *

Parent or Guardian's Signature (if under age 18)

Typing your name above will be your signature

Date

SURVEY (Optonal)

Please check the boxes to indicate the most likely use for your scholarship funds. You may check more than one.