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- SCHOLARSHIP APPLICATION FORM
THE FRANK CHANEY MEMORIAL SCHOLARSHIP FUND A scholarship fund of The St. Croix Valley Foundation 516 Second Street, Suite 214, Hudson WI 54016 INFORMATION SHEET The Frank Chaney Memorial Scholarship Fund is intended to provide scholarship awards to legal dependents of employees of the Andersen enterprise, who demonstrate artistic ability and wish to enroll in an art-related degree program in a post-secondary educational institution. A $12,000 award will be made annually, paid out at $3,000 a year over four years, subject to conditions of the grant. The winner of The Frank Chaney Memorial Scholarship Award will be announced in May. Applications are due on April 1, 2013. The Frank Chaney Memorial Scholarship Fund described here is currently available to all high school students with parents employed within the Andersen enterprise. Locations:
ELIGIBILITY The applicant must meet the following eligibility criteria:
SELECTION
APPLICATION PROCEDURESApplicant distributes the two attached Recommendation Forms, requesting that the individuals providing the recommendations submit the forms as outlined on or before April 1, 2013.
April 1, 2013 to: The Frank Chaney Memorial Scholarship Fund c/o Margi Miller St. Croix Valley Foundation 516 Second Street, Suite 214 Hudson, WI 54016 (Phone: 715-386-9490, mmiller@scvfoundation.org) All materials should be neatly typed. Supplementary materials should be clearly labeled and attached to the Scholarship Application Form. Each piece of the Portfolio should be photographed for submission, in PDF format, on a disc that is clearly labeled with the applicant’s name, address and telephone number plus additional relevant information noted in the Portfolio description. Additional information may be obtained from Margi Miller, Scholarship Services, The St. Croix Valley Foundation, 715-386-9490. Application materials are also available online at: www.scvfoundation.org  THE FRANK CHANEY MEMORIAL SCHOLARSHIP FUND
A scholarship fund of The St. Croix Valley Foundation 516 Second Street, Suite 214, Hudson, WI 54016
 L ast First Middle
2. Home Address: Street City State Zip
Area Code Number ANDERSEN ENTERPRISE EMPLOYEE PARENT/GUARDIAN DATA
Last First Middle
4. Employee Parent /Guardian Employment Status: Active Date Hired:  Retired Date Hired: Date Retired:
Deceased Date Hired: Date Deceased:
5. Parent/Guardian Home Address (if different from applicant): S SCHOOL DATA 1. Current high school: Street City State Zip 2. High school graduation date (month/year): 3. Cumulative high school G.P.A. (on a 4.0 scale): High school art G.P.A.: 4. List art courses taken while in high school (include length of time). Use a separate sheet of paper, if necessary. 
5 . List art/design related courses and extra-curricular artistic activities during the last three years. Indicate where and when these activities occurred. Activities could include exhibitions of artwork, offices held, awards/honors, etc. Use a separate sheet of paper, if necessary.
6. Art teacher(s): Telephone: ( ) 
Telephone: ( ) 
7. Guidance Counselor: Telephone: ( ) 
8. I intend to enroll in the following college/university: (Include address of the Bursar's office or its equivalent.) ____________________________________________________________________________
D PERSONAL STATEMENT Please attach a statement (not to exceed two typewritten, double-spaced pages) of your educational plans and artistic goals as they relate to you personally and to your career goals. Include motivating factors or important experiences which have helped to shape your personal philosophy and/or your educational plans and/ or career goals. Think carefully about this statement. It is very important in the selection process. RECOMMENDATIONS Recommendation letters are being sent to the St. Croix Valley Foundation by: 1  ) Name: Title:
 Address: Telephone:
2  ) Name: Title:
Address: Telephone:
PORTFOLIO Submit a formal portfolio of no more than eight works of art/design. This portfolio will be photographs of the work, NOT the actual pieces, in PDF format, on a disc, clearly labeled with the student’s name. Image one must be a drawing (using any medium) done from a set-up still life subject matter. Do not work from a photograph. Image two must be a self-portrait (personal interpretation) depicted in any medium or combination of media, from drawing to two-dimensional or three-dimensional design concepts. The remaining six works should best represent the applicant's artistic strengths. Drawing, prints, paintings, photography, ceramics, jewelry, fiber art, sculpture, interior design renderings, architectural design and graphic design are acceptable portfolio submissions. Images of all should be submitted, (not the actual piece of art) in PDF format, on a disc. Each image should be labeled with: artist's name, media, dimensions L-W-H, and date of work. Indicate top of image with an arrow. The still life drawing and self-portrait submissions should be identified on the labels of the works. Include a corresponding list of images with the portfolio. The portfolio on a disc must be delivered to the St. Croix Valley Foundation on or before April 1, 2013. Note to applicant: Your application will not be considered unless all materials related to this application, including the (1) Application Form, (2) Personal Statement, (3) two Recommendation Forms, and (4) Portfolio are received on or before April 1, 2013. By signing this application, I am authorizing The St. Croix Valley Foundation and The Frank Chaney Memorial Scholarship Fund Advisory Committee to examine my academic and personal records submitted as part of this application, and verifying that all information is complete and accurate to the best of my knowledge. My signature also certifies that all supplementary materials submitted (except transcripts and recommendations) are my original work. Applicant’s Signature Date THE FRANK CHANEY MEMORIAL SCHOLARSHIP FUND A scholarship fund of The St. Croix Valley Foundation 516 Second Street, Suite 214, Hudson WI 54016
S M  ajor Area of Art Interest:
To the applicant: Complete the top portion of this form and give it to a person best qualified to know your ability as a future college student, supplying that person with a stamped envelope which you have addressed to: The Frank Chaney Memorial Scholarship Fund, c/o Margi Miller, St. Croix Valley Foundation, 516 Second Street, Suite 214, Hudson, WI 54016. (715) 386-9490. To the person completing this form: The student identified above is applying for an art scholarship. Your appraisal of the applicant's potential as a college student will be appreciated. Please comment on all of the following categories: intellectual capacity, creative ability, emotional maturity, level of motivation, skill and craftsmanship, potential for success in a college setting. Use the back of this form if necessary. This student's application will not be reviewed until your recommendation is received by the Scholarship Selection Committee. The deadline date for receipt of this recommendation is April 1, 2013. Comments: H I   n what capacity?
S  ignature:
P   rinted Name
A  ddress:
THE FRANK CHANEY MEMORIAL SCHOLARSHIP FUND A scholarship fund of The St. Croix Valley Foundation 516 Second Street, Suite 214, Hudson WI 54106
Student's Name: 
Major Area of Art Interest: 
To the applicant: Complete the top portion of this form and give it to a person best qualified to know your ability as a future college student, supplying that person with a stamped envelope which you have addressed to: The Frank Chaney Memorial Scholarship Fund, c/o Margi Miller, St. Croix Valley Foundation, 516 Second Street, Suite 214, Hudson, WI 54016 - (715) 386-9490. To the person completing this form: The student identified above is applying for an art scholarship. Your appraisal of the applicant's potential as a college student will be appreciated. Please comment on all of the following categories: intellectual capacity, creative ability, emotional maturity, level of motivation, skill and craftsmanship, potential for success in a college setting. Use the back of this form if necessary. This student's application will not be reviewed until your recommendation is received by the Scholarship Selection Committee. The deadline date for receipt of this recommendation is April 1, 2013. Comments: H I n what capacity?
S ignature:
P  rinted Name:
A ddress:
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