2017-18
Nebraska Council for Exceptional Children (CEC) High School Student Scholarship Application Nebraska CEC annually awards one $500 scholarship to a Nebraska high school senior. The scholarship will be awarded to the most qualified applicant, as determined by the Nebraska CEC Scholarship Selection Committee. All scholarship applications must be emailed to
[email protected] by April 1, 2018. The scholarship recipient will be mailed an official award letter and she/he will be invited to receive the award at our Nebraska CEC conference social event held on May 11th, 2018 at the University of Nebraska—Lincoln. If the award winner cannot attend, the check will be issued to the student and mailed to the recipient by May 15, 2018. It will be the responsibility of the recipient to provide Nebraska CEC with a current mailing address. Award Criteria: Applicants must be a current high school senior with a verified disability according to Nebraska Title 92, Rule 51 within the previous two years. The award will be based upon criteria set forth in the student application along with information submitted by school faculty member and resource teacher/guidance counselor. Application Process: To be considered for this scholarship, please submit the following: 1. Current resume detailing your involvement in various activities and the community. 2. Copy of your high school transcript. 3. Scholarship Application Coversheet (attached). 4. 1-2 page autobiography (12-point font) describing your post-secondary goals and how this scholarship would benefit reaching these goals. 5. Teacher recommendation. 6. Resource Teacher/School Counselor Form (attached). 7. Parent Consent/release form (attached). 8. Picture Release form (attached). Application Deadline and Questions: If you have questions regarding the scholarship application, please contact NE CEC via email to
[email protected].
To be considered for scholarship selection, the completed application packet must be emailed to
[email protected] no later than April 1, 2018.
2017-18
Nebraska Council for Exceptional Children (CEC)
High School Student Scholarship Application Scholarship Application Coversheet (Please print or type) Date: ____________________________
Name: _____________________________________________________________ Last First MI School/Personal Phone: School/Personal E-mail: Permanent Address: _ City
State
Zip
State
Zip
High School Address:
City
Verified Disability Category:
2017-18
Nebraska Council for Exceptional Children (CEC) High School Student Scholarship Application Resource Teacher/School Counselor Form Name of Student___________________________ Name of Teacher/Counselor _____________________ High School__________________________ Current IEP verification category__________________________________________________ (see Title 92, Rule 51 classifications) Brief description of disability limitations____________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Special talents or attributes_______________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ School activities/affiliations______________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________
______________________________________________ _ Resource Teacher/Counselor’s signature
_________________________ Date
2017-18
Nebraska Council for Exceptional Children (CEC) High School Student Scholarship Application Consent and Release Form
(to be completed by parent/legal guardian)
I give my consent to Nebraska Council for Exceptional Children to disclose all information relevant to the application information and verified disability of my child, ____________________, who attends _____________________School, in written materials about the Nebraska Council for Exceptional Children Scholarship Program. I understand that Nebraska Council for Exceptional Children will use these materials for informational or public relations purposes only to enhance the scholarship program.
___________________________________________
___________________
Signature of Parent or Legal Guardian
Date
2017-18 Consejo para Niños Excepcionales de Nebraska (CEC) Solicitud de Becas para Estudiantes de la Escuela Secundaria Formulario de Consentimiento y Liberación (A completar por el padre / tutor legal)
Doy mi consentimiento para que el Consejo para Niños Excepcionales de Nebraska revele toda la información relevante a la información de la solicitud y verifique la incapacidad de mi hijo ____________________ que asiste a la Escuela ____________________ en materiales escritos sobre el Programa de Becas para Niños Excepcionales de Nebraska. Entiendo que el Consejo para Niños Excepcionales de Nebraska usará estos materiales para propósitos de información o relaciones públicas solamente para mejorar el programa de becas.
___________________________________________ ___________________ Firma del Padre o Tutor Legal Fecha
2017-18
Nebraska Council for Exceptional Children (CEC) High School Student Scholarship Application Picture Release Form
I give my consent to Nebraska Council for Exceptional Children (CEC) to publish on the web, in print, electronic, or video format likeness or image of my child, _______________________. I release all claims against the Nebraska CEC with respect to copyright ownership and publication including any claim for compensation related to the use of the materials. I grant permission with the understanding that any publications, photos, videos, etc. will be used in accordance with the Family Educational Rights and Privacy Act and, in general, will positively promote the activities, programs, or services of the Nebraska CEC and its members. I understand that Nebraska Council for Exceptional Children will use these materials for informational or public relations purposes only to enhance the scholarship program.
___________________________________________
___________________
Signature of Parent or Legal Guardian
Date
2017-18 Consejo para Niños Excepcionales de Nebraska (CEC) Solicitud de Becas para Estudiantes de la Escuela Secundaria Formulario de liberación de imágenes
Doy mi consentimiento para que el Consejo para Niños Excepcionales de Nebraska (CEC) publique en la web, en formato impreso, electrónico o en formato de video o imagen de mi hijo, _______________________. Libero todas las reclamaciones contra la CEC de Nebraska con respecto a la propiedad y publicación del copyright, incluyendo cualquier reclamo de compensación relacionada con el uso de los materiales. Yo doy permiso con el entendimiento de que cualquier publicación, fotos, videos, etc. serán usados de acuerdo con la Ley de Derechos Educativos y Privacidad de la Familia y, en general, promoverán positivamente las actividades, programas o servicios de la CEC de Nebraska y sus Miembros. Entiendo que el Consejo para Niños Excepcionales de Nebraska usará estos materiales para propósitos de información o relaciones públicas solamente para mejorar el programa de becas.
___________________________________________ ___________________ Firma del Padre o Tutor Legal Fecha
