Welcome to the Arizona Council of the Blind, AzCB, Scholarship Webpage for 2017. Once again, we are able to provide two scholarships each in the amount of $1000.00. Please read all the eligibility requirements and directions before you begin to complete the application. Whether you win or not, we wish you success in your educational goals and career choice.

 

Sincerely,

 

Barbara McDonald

 

AzCB Scholarship Chair

 

You may also download the 2017 scholarship application and print it out to submit the form

 

Eligibility Criteria:

 

  1. Must be legally blind (see definition below).
  2. Must be an Arizona Resident.
  3. Must have a cumulative GPA of at least 3.25 (on a 4-point scale).
  4. Must be planning to be a full-time student in the fall of 2017.

 

Scholarship Recipient Benefits:

 

  1. A check for $1,000 toward your college education.
  2. Initial membership in the American Council of the Blind, the Arizona Council of the Blind, and any Arizona affiliate of your choosing.

 

Scholarship Recipient Responsibilities:

 

  1. Attend the AzCB Awards Luncheon in the spring - April 22, 2017, in Phoenix.
  2. Write 1 article for the AzCB newsletter, ForeSight - sharing about your college experience.

 

Instructions:

 

  1. All applications and supporting documentation must be received electronically or postmarked by no later than midnight April 12, 2017 (Electronic submissions are preferred.). Any/all supporting documentation can be either emailed as attachments, in Word or PDF formats, or mailed to the AzCB office. Contact information is at the bottom of this form.
  2. Only fully completed applications, with all supporting documents, will be considered.
  3. If an item or section does not apply to you, write N/A.

 

2017 Scholarship Packet Checklist:

  1. Completed application.
  2. Autobiographical Sketch
  3. Proof of Legal Blindness.
  4. Letter of Recommendation.
  5. Official Transcript.
  6. Letter of Acceptance from the school you plan to attend.

 

Personal Information

 

Name: 
Address: 
City: 
State: 
Postal Code: 
Day Phone Number: 
Evening Phone Number: 
Mobile Phone Number: 
Email Address: 
If different from above, Permanent and/or legal contact information:
Permanent/Legal Address: 
Permanent/Legal City: 
Permanent/Legal State: 
Permanent/Legal Postal Code: 
Permanent/Legal Phone Number: 
 
Date of Birth: 
Class level for upcoming fall term: 
Cumulative Grade Point Average: 
Major field of study: 
Career Goal: 
 

 

VISUAL STATUS

 

Note: Legal blindness is defined as visual acuity of 20/200 or less in the better eye, with correction, and/or 20 degrees or less visual field in the better eye, with correction.

 

When did you begin having problems with your vision?  
At what age did you become legally blind?: 
Cause of visual impairment: 
Visual Acuity in Right Eye: 
Visual Acuity in Left Eye: 
Visual Field in Right Eye: 
Visual Field in Left Eye: 
Describe the types of mobility aids you use for travel (cane, dog guide, other): 
What media do you use for reading?: 
What devices and/or technology do you use for reading and writing (e.g., Daisy player, Braillewriter, screen reader, NoteTaker, magnification devices, etc.)?: 

 

EDUCATIONAL BACKGROUND

 

(Entering Freshmen only): High school currently attending: 
High school City: 
High school State: 
High school Cumulative GPA (based on 4.0 scale): 
College or technical college currently attending: 
Current College City:  
Current College State: 
 
Cumulative GPA (based on 4.0 scale): 
Date degree is expected: 
Major(s) and Degree seeking (BS, MA, etc.): 
(if different from your entered Current College data above). Note: Proof of acceptance must be included with application materials. If you will not be notified of acceptance by the time you submit this application, please indicate the date you expect to receive notice from the school(s) (First Choice) Name:
First Choice City: 
First Choice State: 
First Choice Major and Degree: 
 
First Choice Date degree expected: 
:
Second Choice City: 
Second Choice State: 
Second Choice Major and Degree: 
 
Second Choice Date degree expected: 
Please list all schools you have attended during the last four years if not mentioned above. (Attach additional sheet if necessary when emailing or mailing further packet information.) Name: 
City: 
State: 
Starting Date: 
Ending Date: 
Cumulative grade point average (based on 4.0 scale): 
Major and Degree or certificate received (if applicable): 

 

TEST RECORD INFORMATION

 

ACT Date tested: 
Composite Score: 
SAT Date tested: 
Composite Score: 
SAT II Subject: 
Date tested: 
Composite Score: 
Other (GRE, GMAT, LSAT, etc.) specify: 
Date tested: 
Composite Score: 

 

WORK EXPERIENCE

 

 

 

EXTRACURRICULAR ACTIVITIES

 

 

 

Conclusion

 

 
Have you received an AzCB or ACB scholarship in the past? If so list the year(s): 
 
How did you hear about the AzCB scholarship program?: 

 

 

Autobiographical sketch: Please send in your answer in a separate document and describe your personal goals, strengths, weaknesses, hobbies, honors, achievements, etc. Be sure to list the field or courses of study you are pursuing and explain why you have chosen it. Describe How obtaining a scholarship would help your educational experience. This may be emailed to scholarship@azcb.org.

 

Applicants will be notified by April 15, 2017 if selected to receive a scholarship. Please note: In some instances, scholarship awards may be considered taxable income by the Internal Revenue Service.

 

Contact Information

 

Mail any hard copy items to: 

Arizona Council of the Blind
16845 N 29th Ave, Suite#139
Phoenix, AZ 85053

 

Email any supporting documentation to: scholarship@azcb.org

 

If you have any questions, you may email them to Barbara McDonald, the chairman of the scholarship committee. You may call her at 602-285-0269. You may also email the entire committee by sending an email to scholarship@azcb.org.