The Stanley Jay Kurta Cha=
ritable
Trust
We wish to thank you for your interest in applying for= this scholarship. Our good friend Jay Kurta is no longer with us and we wanted to keep him in our minds and in the minds of others. Jay was an exceptional pe= rson, generous, well educated and a very good friend to all that knew him. Jay wa= s a long-standing member of The Club National in Nashua, New Hampshire.
The Stanley Jay Kurta Charitable Trust was created to = honor and preserve Jay’s memory.
Eligibility =
Requirements
- Applicant must be a = High School graduate or have an equivalent GED.
- Applicant must be attending or plan on attending an accredited College or University.
- Applicant must be a =
child, grandchild
Application Process
- It is the applicant’s responsibility to complete this application for scholarship in its entirety and shall include all required documentati= on including checklist.
- A letter from the Cl= ub National member attesting to the applicant's eligibility and member number.=
- Name of College or University with a copy of letter of admission.
- Two (2) letters of recommendation from individuals not related to the applicant.
- All applications mus= t be postmarked no later than March 31, 2012.
- All applications rec= eived are considered confidential and are reviewed only by the Members of the Board of Trustees for The Stanley Jay Kurta Charitable Trust.
- All questions must be directed to: jaykurta@gmail.com<= /a>
Selection of Recipients
- Award Detail=
s
- The recipient will receive a $1,000.00 scholarship that will be paid direc= tly to the College or University on behalf of the student.
- This award must be applied to: tuition, books, fees, or on-campus room and board only.
- Recipient and legal guardian agrees to allow The Stanley Jay Kurta Charitable Tr= ust to use any photographic or electronic image taken of the award recipie= nt for public relation and marketing purposes.
![](3D"JayKurta2012_files/image003.gif")
The Stanley Jay Kurta Cha= ritable Trust Scholarship Application
Personal Information
Student Name Ms./Mr. __________________________________________________
=
Address ________________________________________= ____________________
&nb= sp; __________________________________= __________________________
&nb= sp; City &= nbsp; &nbs= p; &= nbsp; State &= nbsp; &nbs= p; &= nbsp; Zip Code
Home Phone (_____)-(_____)-(_______) E-Mail _____________________________
&nb= sp; = &nb= sp; = &nb= sp; = Optional
High School __________________________________________________________
&nb= sp; School Name = &nb= sp; = &nb= sp; = &nb= sp; State
Year of High School Gradua= tion _______________
College, if currently atte= nding ____________________________________________
&nb= sp; = &nb= sp; Scho= ol Name &nb= sp; = &nb= sp; = S= tate
Year of expected College Graduation ______________
Club National Member’= ;s Name___________________________________________
Club National Member’= ;s Number_________________________________________
Relationship to Applicant _______________________________________________
Academic Information
The school I plan to atten= d is a: (please check)<= span style=3D'mso-spacerun:yes'> &n= bsp; (__) 4 Year College/Universit= y
&nb= sp; = &nb= sp; = &nb= sp; = (__) 2 Year College
Name of school you plan to= attend ________________________________________
Field of Study _____= _________________________________________________
Checklist:
Attach a cop= y of your high school and/or college transcripts.
Attach a cop= y of your SAT/ACT scores.
Attach a cop= y of the Letter of Admission from the college/university you plan to attend.
Activities
Attach a detailed list of all school and community activities in which you have participated. Be sure to incl= ude the year of involvement, your role in each activity, and any honors achieved. Some examples would= be: Athletic involvement in both school and citywide, extracurricular activities such as drama, band, social committees, etc., and community services such as Church, scouts, etc.
Personal
Attach a wri= tten essay, 300 words or less, about “Who you are and what you want to accomplish”.
Attach a let= ter from the Club Natio= nal Member attesting to your eligibility.
Attach two (= 2) Letters of Recommendation from individuals not related to you.
Please mail your completed application as well as all required documentation and letters, postmarked no later than March 31, 2012 to:
Mr. Carl Jean
c/o Greenerd Press & M= achine Co., Inc.
41 Crown St.
Nashua NH 03060
I certify that all informa= tion provided within this scholarship application is true, complete and accurate. The Stanley Jay Kurta Charitable Trust is hereby authorized to verify any information contained in this application. I understand that any falsificat= ion or misrepresentation will result in disqualification.
Applicant’s Signature _________________________________________Date______
Member’s Signature __________________________________________Date______