The enclosed application materials should only be completed by students who are members of the 2006-12 GEAR UP cohort.

For members of the 2006-12 GEAR UP Cohort only

Scholarship & Grant2012 Award Application

All materials must be postmarked or faxed to the GEAR UP office by March 31, 2012.

GEAR UP Virginia - www.gearupva.com State Council of Higher Education for Virginia - www.schev.edu Free Application for Federal Student Aid - www.fafsa.ed.gov Federal Student Financial Aid PIN - www.pin.ed.gov

Helpful Websites

Questions? Contact your school-based GEAR UP coordinator or school counselor if you have any questions. You may also contact the GEAR UP scholarship administrator via email at GEARUPscholarship@schev.edu or call (804) 225-2600.

Award application materials are also available online at www.gearupva.com > Students > 2006-2012 > Forms.

Color - Coded Key

Award Application

Transcript Request Form

Recommendation Form

• Have been a member of the original 7th grade GEAR UP class in 2006-07.

• Have a signed student information release form on file with SCHEV.• Be an active participant in GEAR UP program activities.• Graduate with a high school diploma from a participating GEAR UP high school by

August 31, 2012.

• Have a cumulative grade point average of 2.0 or above by the end of the first semester of their senior year. Must maintain a 2.0 or above through graduation.

• Submit a complete GEAR UP award application and all other required materials to the GEAR UP office by March 31, 2012.

• Be accepted and enrolled at least half-time in an undergraduate degree, diploma, or certificate-seeking program at an eligible institution no later than the second fall semester following high school graduation.

• Successfully complete a Free Application for Federal Student Aid (FAFSA). • Be eligible for and awarded the federal Pell grant.*

* Pell grant eligibility is not required to be considered for the Achievement Grant; however, financial need will be considered when choosing recipients.

Eligible Institutions

An eligible institution is one that:• Is physically located in the state of Virginia. See exceptions below.• Participates in federal Title IV student aid programs, including the Pell grant.• Agrees to participate in the GEAR UP Virginia Scholarship program.

Two Exceptions:

Students may be eligible to receive a scholarship/grant at an institution located in a state that borders Virginia: Kentucky, Maryland, North Carolina, Tennessee, Washington, DC, or West Virginia. These institutions must otherwise meet the requirements listed above.

Students interested in a program not offered at a Virginia institution may be eligible to receive a scholarship/grant at an institution that is not located in Virginia if the school participates in the Academic Common Market (ACM) program and otherwise meets the requirements listed above. Students must apply and be approved to participate in the ACM program in order to be considered for a scholarship.

Scholarship and Grant Requirements

To be eligible for consideration for a GEAR UP Virginia Scholarship or Achievement Grant, a student must:

1.

2.

What You Must Do To Apply

• Successfully complete the 2012-13 FAFSA and be on the lookout for your Student Aid Report via email or mail.

• Complete the attached GEAR UP Virginia 2012 Award application.

• Fill out the attached transcript request form and submit it to your school counselor for processing.

• Complete section A of the recommendation form and submit it to a school administrator, counselor, or teacher who does not work with the GEAR UP program.

• Type/write your essay response and resume.• Make sure all required application materials are submitted to the GEAR UP office by

March 31, 2012. Application materials must be postmarked or faxed by this date.

What Happens After You Apply

Assuming that all of your application materials are mailed or faxed by the deadline, the scholarship committee will review your application packet to determine if you are an eligible scholarship or grant candidate.

Each candidate will receive a letter with further instructions in early May. Candidates will be asked to submit a copy of their college acceptance letter and final high school transcript. Students who are not eligible or selected as candidates will also receive a letter explaining the reason.

Six Required Application Materials

GEAR UP Virginia 2012 Award application (Blue Form)

• Make sure you complete each section of the application. An incomplete application will not be accepted.

• Provide an accurate email address and check it regularly. Email is the primary form of contact for GEAR UP.

• Do not include your name on the FERPA section of the application.• You only need to submit one application to be considered for either award.

Copy of entire Student Aid Report (SAR)• Your SAR summarizes the information you submit on your FAFSA and provides you

with your Expected Family Contribution (EFC). Your EFC is used to determine your financial need.

• Your SAR is sent from the U.S. Department of Education via email in three to five days or by mail in seven to ten days after your FAFSA is processed.

• The FAFSA for the 2012-13 academic year will be available beginning January 1, 2012. • Check with colleges/universities for FAFSA deadlines. • Review the information entered on your FAFSA before submitting.• Most common mistakes made when completing the FAFSA: Incorrect social security

number, misspelled name, incorrect birth date, incorrect or no income reported for student and/or parent.

• You are encouraged to read your SAR comments page to ensure that there are no issues that need to be resolved before submitting to GEAR UP.

• Only submitting your SAR submission confirmation page or summary is not acceptable.

Official Transcript (Orange Form)

• Must include all first semester grades and cumulative grade point average for your senior year.

• Submit the transcript request form early so that your counselor has time to process your request before the deadline.

• You can either have your official transcript mailed from your school directly to the GEAR UP office (recommended) or include the sealed transcript envelope with other application materials.

• Transcripts must remain sealed by the school. Opened transcripts are considered unofficial and will not be accepted.

• Faxed or emailed transcripts will not be accepted.

State Council of Higher Education for VirginiaAttention: Tierney McAuley101 N. 14th Street James Monroe Building, 10th floorRichmond, Virginia 23219Fax: (804) 225-2604, Attention: Tierney McAuley

Six Required Application Materials

Mail or fax application materials by March 31, 2012 to:

Resume• Include name, objective, education, work experience, extracurricular activities,

community service, achievements, and skills.• Do not include GEAR UP activities.

Recommendation Form (Green Form)

• The recommendation form must be completed by a school administrator, counselor, or teacher who does not work with the GEAR UP program.

• Can be mailed by the recommender directly to the GEAR UP office or given to the student for mailing.

Essay • Tell us how one GEAR UP activity influenced your decision to continue your education.• Essays should be typed or clearly handwritten.• Your essay must be at least 250 words, double-spaced if typed.

• Give details.• Follow standard writing guidelines. • Include your name on your essay.

Keep the front portion of this packet for your records.

* Do not fax transcripts.

Tear hereTear here

GEAR UP VirginiaScholarship & Achievement Grant

2012 Award Application

All materials must be postmarked or faxed to the GEAR UP office by March 31, 2012.

INSTRUCTIONS: Read and answer each question carefully. Once completed, return this application to the GEAR UP office using the address provided on the reverse side. Incomplete applications, including those without signatures, will not be accepted. Please print clearly. BIOGRAPHICAL INFORMATION Student’s Full Name: First Middle Last

Social Security Number: Birth Date:

Primary Street Address: Apt:

City, State: ZIP code:

Home Phone: ( ) Cell Phone: ( )

Email (required):

Parents' Names:

High School: Entrance Year:

You are responsible for keeping your contact information up to date with the GEAR UP office. POSTSECONDARY PLAN

Check the term in which you will begin enrollment:

Do you plan to enlist in the military?

Fall/Winter 2012

Spring 2013

Fall/Winter 2013

No

Yes, part-time.

Yes, full-time.

List the institution (college, university, or school) to which you have already been accepted and plan to attend, or the top institutions to which you have applied and are awaiting notification of acceptance.

1.

Institution Name City, State

2.

Institution Name City, State

3.

Institution Name City, State

Continue on back

Continued on back

FERPA INFORMATION RELEASE

In compliance with the Family Educational Rights and Privacy Act of 1974 (FERPA), the student or the parent/ legal guardian (if under 18) authorizes the State Council of Higher Education for Virginia, the Virginia College Savings Plan, the participating GEAR UP school, and the colleges listed on this application to mutually disclose personal identifiable information, including the student’s social security number and any other educational information necessary to verify student eligibility and process scholarship/grant payments. In addition, any persons listed below will be authorized to obtain any educational information pertaining to the student’s GEAR UP award.

Please list the authorized persons below. All information is required in order to be valid. Only persons listed below and the student will be able to obtain information regarding the student’s GEAR UP award.

Do not include student below.

Name: Relationship: Last 4 of SSN:

Name: Relationship: Last 4 of SSN:

CERTIFICATION AND SIGNATURE

By signing below, I certify that:• All of the information I have provided on this form is true and correct to the best of my knowledge.• I authorize the FERPA Information Release as indicated above.• I understand the GEAR UP Virginia Scholarship and Achievement Grant requirements that I must meet in

order to be considered for an award.• I understand that all application materials must be mailed or faxed by March 31, 2012.

Student’s Signature: Date:

Parent’s Signature: Date:(required if student is not yet 18)

MAIL OR FAX YOUR COMPLETED APPLICATION TO:

State Council of Higher Education for VirginiaAttention: Tierney McAuley

101 N. 14th StreetJames Monroe Building, 10th floor

Richmond, Virginia 23219

Fax: (804) 225-2604, Attention: Tierney McAuley

Tear

her

eTe

ar h

ere

STUDENT: Complete this form and submit it to your school counselor. You can either have your official transcript mailed from your school directly to the GEAR UP office (recommended) or include the sealed envelope with other application materials. Transcript envelopes must remain sealed by the school. Opened transcripts are considered unofficial and will not be accepted. Make sure you submit this form early so that your counselor has time to process your request before the mailing deadline. Do not return this form to the GEAR UP office.

COUNSELOR: Official transcripts must include final grades and a cumulative grade point average through the first semester of the student’s senior year. Please make sure the transcript is sealed by the school. Unsealed transcripts are considered unofficial. We recommend that transcripts be mailed from the school directly to the GEAR UP office.

Student’s Name:First Middle Last

Student ID or SSN: Birth Date:

Phone Number: ( ) Email:

High School: Counselor’s Name:

I hereby give permission for my high school to release my official transcript to the State Council of Higher Education for Virginia for the purposes of GEAR UP Virginia Scholarship/Achievement Grant consideration.

Student’s Signature: Date:

If student is not yet 18:

Parent’s Printed Name:

Parent’s Signature: Date:

Mail official transcripts in a sealed envelope to:

State Council of Higher Education for VirginiaAttention: Tierney McAuley

101 N. 14th StreetJames Monroe Building, 10th floor

Richmond, Virginia 23219

Faxed, emailed, or opened transcripts will not be accepted.

Tear hereTear here

GEAR UP VirginiaScholarship & Achievement Grant

Transcript Request Form for Mid-Year Grades

All materials must be postmarked or faxed to the GEAR UP office by March 31, 2012.

Tear

her

eTe

ar h

ere

SECTION A: To be completed by the student.

I, (waive / do not waive) my right to view this completed form.Student’s Name (Circle one)

Signature: Date:

SECTION B: To be completed by the recommender.

1. Please choose the rating that best represents your evaluation of the student for each category.

Categories Excellent Good Average BelowAverage

No Basis for Judgment

Academic achievement

Academic potential

Motivation

Leadership

Self-discipline

2. Please use the space below to summarize your candid thoughts about this applicant. Any additional informationwill be helpful to the committee in deciding between equally qualified applicants. Use space on the back of this form or attach an additional sheet, if necessary.

3. How long have you known this student?

4. How strongly do you recommend this student?

Strongly Fairly strongly No opinion With reservations Do not recommend

Recommender’s Name:

Position or title: Phone: ( )

Signature: Date:

Mail or fax this recommendation form to:

State Council of Higher Education for Virginia, Attention: Tierney McAuley, 101 N. 14th Street, James Monroe Building, 10th floor, Richmond, Virginia 23219

Fax: (804) 225-2604, Attention: Tierney McAuley

Tear hereTear here

All materials must be postmarked or faxed to the GEAR UP office by March 31, 2012.

GEAR UP VirginiaScholarship & Achievement Grant

Recommendation Form