2021-2022 Big Joe Scholarship Application Instructions. Joseph M. Sheetz, “Big Joe”, was the head of Store Development at Sheetz, Inc. for ...
2021-2022 Big Joe Scholarship Application Instructions Joseph M. Sheetz, "Big Joe", was the head of Store Development at Sheetz, Inc. for over 20 years. He was well known by many a s a respected businessman, an avid community member and most importantly, a beloved family man. Joe passed away in August of 2006 from kidney cancer and the Joseph M. Sheetz Scholarship Fund, Inc. was created to honor his memory. Eligibility Requirements To be eligible to apply for a scholarship, an applicant must either be an eligible Sheetz employee or the child/stepchild of an eligible Sheetz employee. An eligible Sheetz employee must have been in active employment and must have worked at least 320 hours (average 10 hours per week) from October 1, 2020 through May 7, 2021. Children/Step-children must be full-time, post-secondary students for the 2021-2022 academic year. Employee applicants may be full -time or part-time students (earning no less than 12 credit hours per academic year). Part time student applicants are eligible for a $5,000 Scholarship. DEADLINE: Applications and all required materials must be receivedat the address below by: May 7, 2021 Applicants are to mail the application with all required materials in ONE business size or larger envelope. Mail applications to: The Big Joe Scholarship Fund C/O Pennsylvania Food Merchants Association Attn: Ellen Markle 144 Chancellor Drive Chambersburg, PA 17201 *If you have any questions regarding the completion of this application, please call Jennifer Hamelin at PFMA (717) 745-3670 or (800) 543-8207 extension3670 or e-mail jhamelin@pfma.net. ALL APPLICANTS WILL BE NOTIFIED OF THE JUDGES' DECISION VIA MAIL BEFORE AUGUST 1. Required materials from schools and employers should be in sealed and signed envelopes in order to be verified as official. P FMA staff will not track down missing materials on your behalf. It is the applicant's responsibility to complete and return all mat erials by the deadline. Any materials or applications received after the deadline may not be considered for judging. Here are some helpful hints to get your materials in on time: 1. Keep only the forms you need to avoid confusion and completion of unnecessa ry forms. If you are a current High School Senior Application H.S. Transcript with SAT scores Essay Employer Recommendation Form* H.S. Guidance Counselor/Principal Form If you are a Post-Secondary Student Application Essay H.S Transcript with SAT Scores College Registrar Form College Transcript (may require a fee) College Dean Form Employer Recommendation Form* *The Employer Recommendation Form is required if the applicant is the qualified employee. If your parent/step-parent is the qualified employee, you are not required to complete this form. 2. Print your name on the bottom line of each form. 3. Forward the required forms to the appropriate person(s). You may want to highlight the instructions and remind them to return the form(s) to you in a sealed and signed envelope, in advance of the application deadline. Materials not officially sealed and signed will not be accepted. 4. Complete your application. DO NOT re-type the application! Handwrite or type in the application if necessary. 5. Write your essay. The essay should be typed on the page provided. 6. Once you have received your materials back from the appropriate person(s), mail these materials, along with the completed App lication, to our office before the deadline. To ensure proper delivery, it is suggested to mail the materials via certified mail or FedEx/UPS. PFMA does not take responsibility for lost mail. 2 2021-2022 Big Joe Scholarship Scholarship Application Form Joseph M. Sheetz, "Big Joe", was the head of Store Development at Sheetz, Inc. for over 20 years. He was well known by many as a respected businessman, an avid community member and most importantly, a beloved family man. Joe passed away in August of 2006 from kidn ey cancer and the Joseph M. Sheetz Scholarship Fund, Inc. was created to honor his memory. Name _____________________________________________________________________________________________________ ___________ Home Address ___________________________________________________________________________________________ ______________ City ________________________________________________ State ____________ Zip Code _________________________________________ Home Phone Number ( ) __________________________________ Date of Birth _________________________________________________ Email Address _____________________________________________ Student Designation - Fall 2021 Freshman Sophomore Junior Senior Graduate Student Required Eligibility Status: (check all that apply) ____ I am a qualified active Sheetz employee who has been in active employment and worked at least 320 hours (average 10 hours per week) from October 1, 2020 through May 7, 2021. ____ I am the child/step-child of a qualified Sheetz employee. ___ I am a full-time college student for the 2021-2022 academic school year. ___ I am a part-time college student (no less than 12 credit hours) for the 2021-2022 academic school year. Employee's Name ______________________________________________ Employee's ID #_______________________ Employment Start Date______________________________ Store Number _____________________ Store City, State _____________________________________________________________________________ The Big Joe Scholarships are awarded without discrimination on the basis of race, color, religion, national or ethnic origin, disability, sex, age veteran status or any other protected class. An independent panel of judges selects winners based on communi ty involvement, leadership, overall excellence of character and academic success. Scholarship awards will be applied toward the recipient's tuition to attend a p ost-secondary institution. Scholarships will be paid directly to the schools that the winners attend. Payment may not be postponed to another academic year. Applicants agree to accept the independent judging panel's decision as final. I have read and understand the instructions. I understand that it is my responsibility to collect all required ma terials and send them to the PFMA office before the deadline. Signature_________________________________________________ Date ________________________________________ Applicant's Name____________________________________ 3 Mother's First and Last Name ________________________________________________________ ________________________ Step-Mother's First and Last Name ____________________________________________________________________ Father's First and Last Name _____________________________________________________________________________ ____ Step-Father's First and Last Name _____________________________________________________________________ School attending in Fall 2021 (ifapplication(s) are pending, list school(s)applied to) ____________________________________________________________ _______________________________________________ ___________________________________________________________________________________________________________ Planned area of study ________________________________________________________________________________________ Has your education ever been interrupted? Ifyes, explain when and why. ____________________________________________________________________________________________ _______________ ___________________________________________________________________________________________________________ School currently attending ______________________ Anticipated Date of Graduation (MM/YY) _____________________ Is it a High School or a College? (Please mark one) ________High School _______College/Post Secondary School Former High Schools and/or Post Secondary Schools and years attended School Name ___________________________________________________________ ___________________________________________________________ Work Experience: (please list your current or most recent job) List Years Attended (i.e. 2017-2021) ___________________________________ ___________________________________ Company Name ________________________________________________________________________________________ Company Address ______________________________________________________________________________________ Company City, State & Zip _______________________________________________________________________________ Company Phone ( ) ______________________ Your Job Title _______________________________________________ Average Hours per Week ____________________ Months/Years Worked ________________________________________ Applicant's Name____________________________________ Using only the spaces provided, please list the following: In-school Extra-Curricular Activities (list most recent first) Activity Dates of Activity (Month / Year) ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ Community Service/ Activities (list most recent first) Name of Organization _______________ _______________ _______________ _______________ _______________ _______________ _______________ _______________ Dates of Service (Month / Year) ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ Leadership Role(s) (in or out of school) Name of Organization _______________ _______________ _______________ _______________ _______________ _______________ Role/Position ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ _______________ _______________ _______________ _______________ _______________ 4 Hours / Weeks High School or per week / per year College Activity (check one) ________/________ HS C ________/________ HS C ________/________ HS C ________/________ HS C ________/________ HS C ________/________ HS C ________/________ HS C ________/________ HS C Hours / Weeks High School, per week / per year College or Other Activity (check one) ________/________ HS C O ________/________ HS C O ________/________ HS C O ________/________ HS C O ________/________ HS C O ________/________ HS C O Dates of Service (Month / Year) High School or College or Other Activity (check one) ________________ HS C O ________________ HS C O ________________ HS C O ________________ HS C O ________________ HS C O Awards, honors or prizes ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Applicant's Name____________________________________ 5 2021-2022 Big Joe Scholarship Personal Essay (All Applicants) (Your personal essay should be typed, double-spaced in New Times Roman (12 font), on the page provided. Remember to proofread, check punctuation, paragraphing, and grammar. Please set your margins as follows: Top, 3.5", bottom 1.5", sides 1". Word count should not exceed300 words.) How has your community service inspired you? If you had unlimited time and resources what need would you fulfill for your community? Describe how you came to believe this need existed and describe what you would do to fulfill this need? Applicant's Name____________________________________ 6 2021-2022 Big Joe Scholarship Applicant's Employer Recommendation (If applicant is a qualified Sheetz employee) To the Employer: _____________________________has applied for a 2021-2022 Big Joe Scholarship. Please complete this form and put it in an envelope. Seal and sign the back of the envelope and return it to the applicant by Friday, April 23, 2021. Employee Start Date: _________________________________ Please describe how well the candidate carries out his or her assigned duties. Please describe the candidate's ability to interact positively withyour customers. Additional Comments regardingthe applicant: Store/Department Manager's Name (Printed) and Signature __________________________________________________________ Store Number or Department Name ______________________________________________________________________ ___________ Applicant's Name____________________________________ 7 2021-2022 Big Joe Scholarship High School Guidance Counselor/Principal Form (Required for 2021 high school student/graduate only) Joseph M. Sheetz, "Big Joe", was the head of Store Development at Sheetz, Inc. for over 20 years. He was well known by many as a respected businessman, an avid community member and most importantly, a beloved family man. Joe passed awayin August of 2006 from kidney cancer and the Joseph M. Sheetz Scholarship Fund, Inc. was created to honor his memory. To the Guidance Counselor/Principal: _____________________________ has applied for a 2021-2022 Big Joe Scholarship. Please complete this form and attach an official transcript including SAT/ACT scores OR copy of score report. Please put all the materials in an envelope from your school. Seal and sign the back of the envelope and return it to the ap plicant by Friday, April 23, 2021. The applicant's cumulative grade point average was ___________ on a scale of __________. The applicant's class rank was _____________ in a class of _______________. Date of graduation __________________________________. SAT Scores: Before March 2005 ______ Highest Verbal + ______ Highest Math = _______ Highest Total (out of 1600) After March 2005 ______ Highest Critical Reading + ______ Highest Math + ______ Highest Writing = _______ Highest Total (out of 2400) ACT Score: _______ Highest ACT Score Comments: Counselor's/Principal's Name (Printed) and Title _________________________________________________________________________ School Name _________________________________________________________________________________________________________ School Address ________________________________________________________________________________________________________ City __________________________________ State _______________ Zip Code ___________________________________________________ Applicant's Name____________________________________ Phone ( ) __________________________ Fax ( 8 ) ___________________________ Date _______________________________________ 2021-2022 Big Joe Scholarship College Registrar Form (For current post-secondary students) Joseph M. Sheetz, "Big Joe", was the head of Store Development at Sheetz, Inc. for over 20 years. He was well known by many as a respected businessman, an avid community member and most importantly, a beloved familyman. Joe passed awayin August of 2006 from kidney cancer and the Joseph M. Sheetz Scholarship Fund, Inc. was created to honor his memory. To the Registrar: _____________________________ has applied for a 2021-2022 Big Joe Scholarship. Please complete this form, attach an official transcript and put it in an envelope from your school. Seal and sign the back of the envelope and return it to the applicant by Friday, April 23, 2021. The applicant has a cumulative grade point average of ______ on a scale of ________________. The applicant's class rank is _____________ in a class of _______________. Anticipated date of graduation: ______________________________________. Comments: Registrar's Name (Printed)and Signature _____________________________________________________________________ School Name _______________________________________________________________________________________________ School Address _______________________________________________________________________________________ ______ City _____________________________________________ ____ State ________ Zip Code ________________________________ Phone ( ) _____________________________ Fax ( ) _____________________________ Date_______________________ Applicant's Name____________________________________ 9 2021-2022 Big Joe Scholarship Dean's Report Form (For current post-secondary students) Joseph M. Sheetz, "Big Joe", was the head of Store Development at Sheetz, Inc. for over 20 years. He was well known by many as a respected businessman, an avid community member and most importantly, a beloved family man. Joe passed awayin August of 2006 from kidney cancer and the Joseph M. Sheetz Scholarship Fund, Inc. was created to honor his memory. To the Dean: _____________________________ has applied for a 2021-2022 Big Joe Scholarship. Please complete this form and put it in an envelope from your school. Seal and sign the back of the envelope and return it to the applicant by Friday, April 23, 2021. 1. Is this student in satisfactory academic standing at your institution? (If "no," please explain on Yes No the reverse.) 2. Is this student in satisfactory non-academic standing at your institution? (If "no," please explain Yes No on the reverse.) 3. Would you permit this student to continue at your institution? (If "no," please explainon the Yes No reverse.) 4. Has this student, to your knowledge, ever been involved inanypersonal, social or academic Yes No difficulties of whichyou feel the Big Joe Scholarship judging panel should be aware? (If "yes," please explainon the reverse.) 5. Would you give this student a good character recommendation? Yes No 6. Are your responses to these inquiries basedon (please check all that apply): _______ Records/reports? _______ Counseling/advising contacts? _____ Close personal acquaintance? _____ Casual contacts/observations? Please give any other information, which you believe to be relevant. Thank you. Dean's Name (Printed) and Signature _____________________________________________________________________ School Name ___________________________________________________________________________________________ School Address _________________________________________________________________________________________ City ______________________________________ State ___________ Zip Code ____________________________________ Phone ( ) __________________________ Fax ( ) ___________________________ Date _________________________ Applicant's Name____________________________________Microsoft Word 2016 Microsoft Word 2016