Avon Club Foundation Application for the Avon Club Foundation Kathy Hall Memorial Scholarship

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Avon Club Foundation

Application for the Avon Club Foundation Kathy Hall

Memorial Scholarship


Under the direction of the

Scholarship Committee 2015

Directions for Completing Application

  1. Complete all forms of this application. If a form is not completed, the application will not be considered.

  1. Contact Amy Baschnagel if you have any questions about the application.

abksikora@gmail.com with the subject line labeled Kathy Hall Memorial Scholarship.

  1. Mail the completed application and reference requirements to:

Avon Club Foundation

Attention: Amy Baschnagel, Scholarship Committee

159 Neville Ave

Pittsburgh, PA 15202


Note: The application must have a postmark date no later than

April 8th, 2015

  1. Applicants will be notified with information regarding the award announcement and presentation details.

Scholarship Evaluation Rubric
Essay: 50%
Extracurricular: 30%
GPA: 20%
Applicant Information
Name: ________________________________________________________
Address: ________________________________________________________
City: ___________________________ Zip: ___________________________
Telephone: ______________________ Email: __________________________
Date of Birth: ___________________
High School Attending: ______________________________________________
GPA: __________________________ Date of Graduation: ______________
*A weighted Transcript is required with application.
Note: If you feel it necessary to explain your GPA, please include a statement below:

Continuing Education Information
List your top 3 colleges, universities, and/or other institutions to which you have applied. Also indicate the status of admission acceptance.

Name of School

Acceptance Status

  1. _______________________________________

Yes _____

  1. _______________________________________

Yes _____

  1. _______________________________________

Yes _____

Please list your 1st and 2nd choice courses of study you plan to follow.

  1. ___________________________

  1. ___________________________

Personal Reference Information
List 2 people you have selected as your references:

One (1) teacher/counselor/or administrator, and one (1) employer/volunteer supervisor/or coach. Please include a reference letter from each with the completed application.




  1. ________________




  1. ________________




Extracurricular Activities
List any scholastic, athletic, or other activities at your school or community in which you have taken part during your high school years. Include the dates when you participated in each activity.


Dates Participated

List any summer or part-time work during your high school years.

Summer or Part-Time Work Location

Dates Employed

List any volunteer work during your high school years.

Volunteer Work Location

Dates Volunteered

Essay Information
Include a brief essay, response to the following prompt.

Times New Roman (12pt,) with a 1000 word minimum, at least 1.5 spacing. Use 1 inch margins.

To so many, Kathy Hall was a role model, a confidant, a teacher, and aptly described as a professional best friend.  Her laughter, courage, grace, kindness, selflessness and energy were her trademarks. Which of these attributes do you most identify with? Why do you think these attributes are important to have? When have you exhibited these characteristics and how might they help you in your future?

Applicant Signature: _________________________________________________
Parent/Guardian Signature: ____________________________________________
Guidance Counselor Signature: ________________________________________

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