Missouri BETA Club
 Scholarship Application










(Note: These pages were prepared with Netscape Browser; Internet Explorer may print differently).

General Rules:

1.    Print this application form.  Copy it as many times as needed.  Use copies of this form
ONLY.  Do not add auxiliary pages.  Be sure applicants submit 2 reference pages.

2.    All forms must be typed.

3.    A senior BETA member in good standing who is interested in attending one of the colleges or universities listed below is eligible to apply for the scholarship.

4.    The State BETA Council Chairman will appoint a team to screen all applications that will be presented to the State BETA council.  Three candidates (unless the Council feels that others should be considered) will be selected to be presented to the Council for first selection interviews.

5.    The Missouri BETA Council will act as the board of review to interview the selected applicants and choose the scholarship recipient at the State Convention on Saturday (time and place to be announced Friday night).

6.    The recipient and an adult representative from his/her club must be in attendance at the State Convention in March when the scholarship is awarded.

7.    A SEPARATE APPLICATION FORM MUST BE COMPLETED FOR EACH COLLEGE OR UNIVERSITY TO WHICH THE STUDENT WISHES TO APPLY.

8.    The Application must be sent certified mail. DO NOT MAIL TO THE UNIVERSITY.

Applications For:                                               Applications For

           Missouri State                                          Southeast Missouri State
                    and/or                                                            and/or
           Truman  State                                            Three Rivers Community College

Send to:                                                            Send to:
        Mr. Derek Urhahn                                            James Watts
        BETA Scholarship                                            BETA Scholarship
        Dexter High School                                          Lesterville High School
        1101 W. Grant Street                                      33415 Highway 21 PO BOX 120
        Dexter, MO  63841                                         Lesterville , MO  63654-0120
 

9.    APPLICATION FORMS MUST BE POSTMARKED BY THE DEADLINE DATE OF JANUARY 27, 2014.
 
 

VALUE OF SCHOLARSHIPS OFFERED

These scholarships are provided to the Missouri Beta Club for the active senior students who meet all qualifications and are selected by the Missouri Beta Council.  The following information is accurate and complete to the best of the knowledge of the members of the Missouri Beta Council.  Any changes in the value of the scholarships will be at the discretion of each school who provides the scholarship.

Missouri State:
        Full tuition with room and board in specified campus housing.  Renewable if maintain 3.5 GPA with minimum of 30 hours cumulative per year.

Truman State:
        Full time tuition  - exact value will be determined when 2009-2010 rates are set.  The award will be potentially renewable at that specified dollar value through four years of undergraduate study at Truman if the recipient meets scholarship renewal requirements, which will be provided in detail to the recipient.

Southeast Missouri State:
        Full tuition up to 16 hours per semester up to 32 hours per year. Room and board in specified campus housing.  Renewable for eight semesters.  Must maintain 3.5 GPA with a minimum of 30 hours cumulative per year.

Three Rivers Community College
        Full tuition plus rental books and fees.  Must maintain a 2.5 GPA each semester and complete at least 12 hours successfully.  Renewable for 4 semesters (fall and spring).
 

NOTE:  All schools who offer scholarships will also offer other scholarships of similar value.  Scholarships such as Board of Governors, Freshman Academic, and/or Freshman Achievement Scholarships cannot be duplicated with the Missouri BETA Scholarship.

(Scroll down to Section I of scholarship application form)
 
 

















Missouri BETA Club
 Scholarship Application Form









SECTION I        Information to be supplied by the applicant.  Please type.

TO WHICH COLLEGE OR UNIVERSITY ARE YOU MAKING APPLICATION?

_________________________________________________________________________

Name                                                                      __________Social Security No.________
            (first)              (full middle name)                 (last)

School Name:______________________________Location:_________________, Missouri

Full name of
Parent or Guardian:_________________________________________________________

Permanent Address
of Parent or Guardian:_______________________________________________________
                                   (street, box, or route)             (town)                (state)             (zip)

The applicant must use the remaining space to write an explanation of your future plans for your education, goals you have set for yourself.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

SECTION II        Information to be supplied by the applicant.  Please type.

SCHOOL ACTIVITIES:

List activities in which you have participated during high school. Include clubs, teams, musical groups, etc.  Note major accomplishments in each.  Select no more than ten (10)
 

  Year
9 / 10/ 11/ 12         Activity        And           Accomplishments
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
 

LEADERSHIP POSITIONS:

List elected or appointed leadership positions held in school, community, or work activities.  Only those positions in which you were directly responsible for directing or motivating others should be included.  For example:  elected student body, class or club officer; committee chairperson; team captain; newspaper editor; work area manager or community leader.  Select no more than ten (10).

Year
9 / 10/ 11/ 12/                 Leadership Position                Activity or Organization
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
 
 
 
 
 
 

SECTION III    Information to be supplied by the applicant.  Please type.

COMMUNITY ACTIVITIES:

List community activities in which you have participated and note any major accomplishments in each.  These should be any activities outside of school in which you participated for the betterment of your community.  For example:  church groups, clubs sponsored outside the school, Boy or Girl Scouts, volunteer groups, or community art endeavors.  Select no more than ten (10).

Year
9 / 10/ 11/ 12                Community Activity        And        Major Accomplishments
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
 

WORK EXPERIENCE, RECOGNITION, AND AWARDS:

List below any job experiences, honors, or recognition that you have received which support your bid to be a leader.  Select no more than ten (10).

Year
9 / 10/ 11/ 12    Job, Recognition, or Award                            Group or Activity
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
__/__/__/__    ____________________________________________________________
 
 
 
 
 
 

.
 

SECTION IV    Information to be supplied by the High School Principal or Counselor.

Student Name ________________________________________________________
                        (first)                       (full middle name)                       (last)

The above applicant is ranked _________based on the first seven semesters.

There are _____seniors in the class.  The applicant will graduate ______________.

Indicate applicant's scores on one of the following college aptitude test (use ACT if available).
______________________________________________________________________
        Date
        Tested                                Raw Score                                Percentile Rank
______________________________________________________________________
ACT                                                           Sci.                                                  Sci.
ACT                        Eng    Math    Read    Reas    Com    Eng    Math    Read    Reas    Com
ACT                        ____ ____    ____   ____    ____    ____   ___    ____    ____    ____
_______________________________________________________________________
_______________________________________________________________________

SAT                            Verbal        Math                           Verbal        Math
SAT
SAT                            ______    ______                            ______    ______
_______________________________________________________________________

Enclose a copy of the student's high school transcript reflecting seven semesters.

(Signed)___________________________________ (Title)_________________________

Name of school    _____________________________________

School address   _____________________________________
                            _____________________________________
                            _____________________________________
                            _____________________________________

Date  ____/____/____

(THIS INFORMATION SHOULD BE ENCLOSED IN A SEPARATE SEALED ENVELOPE AND MAILED WITH THE APPLICATION)
 
 
 
 
 
 
 
 

SECTION V   TWO Reference  pages must be completed by teachers selected by applicant
                        Each teacher should place completed reference in sealed envelope and mail
                        with the application.
Name of Student_________________________________________
Name of School__________________________    Teacher Signature__________________

Instructions: Circle the number value in each CATEGORY which most closely describes the student.
------------------------------------------------------------------------------------------------------------------------------------------------
INDUSTRIOUSNESS - Willingness to work, work habits, zeal, perseverance.
Lazy, little or            Seldom                         Ordinarily                    Occasionally does                    Does extra work
no effort.                  completes work.          completes work.         extra work .                                gladly.
    0                                    1                            2            3            4             5            6            7             8        9        10
------------------------------------------------------------------------------------------------------------------------------------------------
THOROUGHNESS - Accuracy, carefulness, exactness
Careless. Work is        Express ideas        Work generally                Careful work.                        Very careful and
always incomplete.      carelessly.             complete & accurate        Accurate.                             thorough.
     0                                    1                            2            3            4             5            6            7             8        9        10
------------------------------------------------------------------------------------------------------------------------------------------------
INITIATIVE - Intellectual curiosity, willingness to attempt new ideas, asks questions, shows interest.
Never tries                Seldom originates    Sometimes                        Often initiates                  Marked ability to
anything new.          any work.                   attempts new ideas.        undertakings.                  think independently
     0                                    1                            2            3            4             5            6            7             8        9        10
-------------------------------------------------------------------------------------------------------------------------------------------------
RELIABILITY - Dependability, good judgment, honesty, ability to get along without supervision
Dishonest. Neglects    Often needs        Sometimes reliable.           Usually assumes                    Thoroughly
obligations.                   supervision.        Needs prompting.            obligations.                              dependable.
     0                                    1                            2            3            4             5            6            7             8        9        10
-------------------------------------------------------------------------------------------------------------------------------------------------
COOPERATION - Ability to get along with others, adaptable, tactful, agreeable, cheerful.
Disagreeable.                Slow to respond.         Tends to be                   Does well in team               Always willing
Neglects obligations.   Not willing to help.    agreeable & willing       work. Agreeable.                to help others.
     0                                    1                            2            3            4             5            6            7            8        9        10
------------------------------------------------------------------------------------------------------------------------------------------------
EMOTIONAL STABILITY - Poise, ability to handle stress.
Unable to control        Occasionally loses        Fairly well balanced.    Well balanced                       Exceptionally
emotions.                       self control.                   Good control.                Poised                                    well poised.
      0                                    1                            2            3            4             5            6            7             8        9        10
-------------------------------------------------------------------------------------------------------------------------------------------------
INTELLECTUAL CAPABILITY - Intelligence, natural ability to succeed in academic effort.
Very slow to learn.        Needs to make extra        Average                   Quick to grasp                        Gifted.
Lowest one/fifth.            effort to keep up.            intelligence.            subject.                            Highest one/fifth.
     0                                    1                            2            3            4             5            6            7             8        9        10
------------------------------------------------------------------------------------------------------------------------------------------------
RECOMMENDATION - Based on the ratings on this form, this applicant is:
Not recommended.        Recommended                Recommended            Recommended                    Very highly
                                        with reservations.                                                  with confidence.               recommended.
     0                                    1                            2            3            4             5            6            7             8        9        10