MOUNT VERNON STAR SCHOLARS APPLICATION
The Mount Vernon Star Scholars (MVSS) Program is a two year mentoring program designed to assist a select group of gifted students at Mount Vernon high schools to gain admittance to selective U.S. colleges and universities. There is no cost to participate in this competitive program. Students should submit their applications during the second semester of their sophomore year; Scholars will be designated during the summer between the sophomore and junior year.
Home Phone ____________________________________________________
Cell Phone ____________________________________________________
Email Address ____________________________________________________
Date of birth ____________________________________________________
Parent/Guardian’s Name ____________________________________________________
Parent/Guardian’s Address ____________________________________________________
Grade Point Average ____________________________________________________
Note: Students must have a minimum GPA of 85 or equivalent to qualify for the MVSS Program.
Please attach on a separate sheet
Please list any extracurricular/non-academic activities in which you are currently involved or have been in the past two years
Please attach on a separate sheet. 250 words or less per question.
1. Why should you be chosen as a Mount Vernon Star Scholar? How would you benefit by participating in the program?
2. What do you hope to achieve with your college education and where do you see yourself in 20 years?
3. Describe what you have learned from your participation in non-academic activities (listed above) during your high school years.
4. Describe any obstacles that you have had to overcome to achieve your current level of success. What do you see as the biggest obstacle(s) to your future academic success?
Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 7th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in disciplinary action? These actions could include, but are not limited to: probation, suspension, removal, dismissal, or expulsion from the institution.
Yes _______ No _______
Have you ever been adjudicated guilty or convicted of a misdemeanor, felony, or other crime?
[Note that you are not required to answer “yes” to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a court to be kept confidential.]
Yes _______ No _______
If you answered “yes” to either or both questions, please attach a separate sheet of paper that gives the approximate date of each incident, explains the circumstances, and reflects on what you learned from the experience.
Additional Materials Required
Please provide the following along with this application and your response to the essay questions:
High School Transcript and copy of most recent report card (Please note that students must maintain a minimum 85 GPA throughout the mentoring program.)
PSAT Score report
Two Letters of Recommendation -- one from a current or past teacher, one from a community member or employer (not a family member)
Application packages should be submitted to your guidance counselor.
If you have any questions about this application please contact firstname.lastname@example.org.
The Parent/Guardian consents to the participation by the Student in all activities associated with the MVSS Program. The Parent/Guardian and Student acknowledge that some of those activities include, without limitation: (i) meetings with a mentor at times and places convenient to the mentor; (ii) traveling unaccompanied to and from meetings with a mentor; (iii) traveling with a mentor to college campus visits (which may require overnight stays and/or travel outside the State of New York); and (iv) videotaping, photographing, interviewing or otherwise recording the Student (“Media Material”). The Student and Parent/Guardian acknowledge that MVSS owns the Media Material and the Student and Parent/Guardian grant MVSS the right to edit, use and reuse the Media Material for non-profit purposes.
The Student and Parent/Guardian understand that the Student is expected to behave responsibly and follow the school’s code of conduct and policies at all times and that, if the Student violates such policies, the Student may be precluded from participating in the MVSS Program. For and in consideration of the Student’s participation in the MVSS Program, the Student and Parent/Guardian each release, to the fullest extent permitted by law, MVSS and its trustees, employees, volunteers, mentors or other agents from all claims and liabilities that arise from any and all activities in connection with the MVSS Program including claims or liability caused by or related to the negligence of any such party.
PARENT/ GUARDIAN SIGNATURE