Required Documents Electronic documents are required to yerify disclosures you made in the Eligibility Questionnaire and in your application. All documents must be uploaded through this page before you can successfully submit your application. Tips: in Only one document can be selected and uploaded per section at a time. In You may upload more than one document in the same place. For example, ifyou uploaded an incorrect yersion ofyour 2018 tax return, you can submit the correct yersion to the same section. in You will not be able to view or delete documents once you upload them, but you can see the title ofthe documentls] that you haye uploaded. If you think you made a mistake the first time, simply upload the new documents in the same place eyen after the box turns gray. In You may be required to provide additional documents as we review your application, so be sure to check both this page and your email frequently for additional information requests after the application deadline. Uploaded documents must be either a pdf, an image Upg,jpeg, bmp, tif], or a Word document. Upload Photo Due: ll?Si?EDlS Please upload a professional?looking headshot of yourself [.jpg, _png, -gif format]- Uploaded Pictures: Select Picture No pictures uploaded- Upload Picture Student Proof of U.S. Citizenship or Permanent Resident Status Due: ll?Si?EDlS Acceptable documents include a copy of your U.S. birth certificate, US. passport, permanent resident card, certificate of citizenship, or certificate of naturalization No documents received- Upload Document DU e: ll? Student Proof of State Residency Acceptable documents include a copyr of your driver's license, learner's permit, state issued identification card, or high school transcript loaded Files: Select Document No documents received- Upload Document ll? Student ACT or SAT Score Sheet This is the official ACT or SAT score sheet CIR a copy of the official high school transcript with the ACT or SAT composite and component scores- loaded Files: Select Document No documents received- Upload Document ll? Parentls} Federal Tax Retu rnls} Copy of your Parent{si 2013 tax return including all schedules Select Document Uploaded FIIESI No documents received- Upload Document Proof of Full?Time Enrollment Provide a copy of an academic schedule or current school billing statement, including the academic year- No documents received- Upload Document We require one document for each dependent listed: Due: ll?SfEDlEi Proof of Full?Time Enrollment Provide a copy of an academic schedule or current school billing statement, including the academic year Select Document Uploaded No documents received- Upload Document We require one document for each dependent listed: Du e: ll? foicial High School Transcript No documents received. Upload Document Due: ll?SfEDlE} ?cplicant Information Required Social Media Accounts Please enter the URL or userneme of your social media accounts below. If you do not have one, enter "ndne". Fecebeek Link: Twitter Hendle: Instagrem Userneme: Bldg: Tumblr: Snapchet: YouTu be: Pinterest Reddit ?t her: Howyou spend your time in a typical week during the school year Think carefully about how you spend a typical week outside of the classroom during the school year. Then complete the table, rounding to the nearest hour. Togetherr the total of all hours must equal 50, the average number of waking hours during a week. not including the average time spent in classr sleepingr eating mealsr and preparing for the day. How do you spend a typical week? Studying outside of class {study hallr tutoringr homework etc}: Cl Volunteering: Drganized activities (extracurricular, in school activities, sports, community groups, parks 3; recreational programs, etc}: 0 Religious actiyities [include time spent in church, religious camps, youth groups, etc.) Working on a farm or ranch: Household and family responsibilities: Ci Jopf'paid employment: Friends, socializing [do not include testing or electronic social media]: Ty?, moyies, computer games, and testing or electronic social media such as Facepook, Instagram, SnapChat, etc.: Preparing for college {researching schools, test prep, college applications, scholarships, etc]: Total Hours: 0 This value must ecluair 50. Pfease revise your answers. San-?e a nd Next Page Scan for lie-1 issi :1 an serL Add A Recom mender Required Recommendation must be submitted by November 15, 2013 at 4:00 p.m. MST As part of the application, students must obtain a recommendation from a representative at the applicant's high school leg, principal, teacher, guidance counselor, coach, etc). Your recommender is an individual who can provide candid, detailed responses about you based on the scholarship selection criteria. Be very thoughtful about selecting your recommender. Recommenders must be at least 21 years of age and cannot be related to you. If you are homeschooled, your high school representative is most likely a family member. Since you cannot be recommended by a family member, you will need to contact someone from the district that your homeschool is associated with and request their recommendation. Any school representative, such as a coach, music instructor, guidance counselor, etc., can complete the recommendation for you. Dnce you have added and saved the contact information for your recommender, they will receive an email from the Daniels Fund with login information and instructions on how to complete their recommendation. We strongly encourage you to speak to your recommender ahead oftime, so they know to expect an email from the Daniels Fund. Your recommender will complete and submit their recommendation online. Faxes and emails will not be accepted. Be sure to give your recommender plenty of time to complete their recommendation prior to the application deadline. It is your responsibility to ensure your recommender receives the information they need and submits their recommendation, so be sure to follow up with your recommender in person. If the recommendation is not submitted by the deadline, your application will not be considered. Make sure the information you provide below is correct. Recommender High School Representative Form must be filled out completely before saying. First Name: Last Name: Recommender Email: *Confirm Email: Relationship: No Selection Phone Number: Ext. An email has been sent to your recommender asking them to submit a recommendation to the Daniels Fund on your behalf. Your recommender has registered for an account. You can change your recommender at any time by visiting this section. updating the recommender's contact information above, and clicking the Update Recommender button below. il- Com munity Involvement a nd Volu nteer Experience Required In order of importanceI list the community and volunteer activities that you have found to be the most meaningful during your high school years. These typically are activities associated with a nonprofit organization, a religious group or church, or a community?based organization. We understand there may not be enough space to list all ofthe activities you are involved in. Do not include extracurricular activities in this section, as there is a designated section entitled Extracurricular Activities. We do not want duplicate entries. List the volunteer activities that are the most meaningful to you and respond to the questions with the answer that is the best match. Most Meaningful Organization Name: Organization Type: Please Select 1h Provide a short description of what you did at the organization: Grade levels participated: 9D 10D 11D 12D How did you first become involved? Please Select 'll' Second Most Meaningful Organization Name: Organization Type: Please Select Provide a short description of what you did at the organization: Grade levels participated: 9D 1oD 11D 12D How did you first become involved? Please Select Third Most Meaningful Organization Name: Organization Type: Please Select ill Provide a short description of what you did at the organization: Grade levels participated: 9D 10D 11D 12D How did you first become involved? Please Select Cetting to know you Please select the answer that best indicates how much you agree or disagree based on a "typical" situation: had academic problems, I would ask for help. Please Select I know the areas where I have weaknesses. 1h Please Select I am good at controlling my feelings when I need to. Please Select i Similar to high schoolr eyeryone should be able to go to college for free. Please Select i I enjoy helping others. Please Select i I often come up with solutions to my friends' problems. Please Select i I usually know when We said something inappropriate. .I. Please Select America the Beautiful is the National Anthem. 1h- Please Select naturally take on leadership roles. .I. Please Select have difficulty changing my behayior to suit different situations. .I. Please Select I think it's better to haye a firm set of personal beliefs. Please Select . Government should reduce income differences. ill Please Select When I belieye strongly in something. I act on it. Please Select i There are a limited number of opportunities to make an impact on the world. .I. Please Select . Usually, lam able to solye problems. Please Select i have difficulty seeing things from others' point of View. Please Select I would consider time management one of my weaknesses. Please Select Businesses only benefit the wealthy. Please Select i I would prefer to in a different country. Please Select i rCine of my goals is to start my own business. Please Select I can think on my feet. A Please Select In college. I expect to change my major a few times. A Please Select Failure means that I try harder next time. A Please Select I want to do something big in my life. A Please Select Save and Next Page Scan for Missing Answers En?iployn?ient {including unpaid FarmfPa work] Peduired Current Employment Status Do you currently have a job? 1: YesEl Mom If No, what statement best describes why you do not have ajob? II- Please Select Please list your most recent jobs. Include anyjobs held over the last three years. Job] Job Position or Title: Primary Duty: Name of Company, Firm, Drganization, or Indiyidualz Currently Employed? Yes No Crade levels employed: 9D 10D 11D 12D Classify Employment Type: Please Select 1h What statement best describes how you utilizeld} the majority of your income from thisjob? Please Select 4h- Job 2 Job Position or Title: Primary Duty: Name of Company, Firm, Organization, or Individual: Currently Employed? Yes : No Grade levels employed: 9D 10D 11D 12D Classify Employment Type: Please Select db- What statement best describes how you utilizeld} the majority of your income from thisjob? Please Select Job 3 Job Position or Title: Primary Duty: Name of Company: Firm, Organization or Indiyidual.? Currently Employed? Yes No Grade levels employed: 9 10 12 Classify Em ployment Type: Please Select What statement best describes how you utilizeld] the majority of your income from thisjolo? Please Select Save a nd Next Page Scan for issi ng en swer's di- Extracurricular Activities Required In this section, include information about the extracurricular activities in which you participate. These activities may occur at school, but others might be interests to which you dedicate time outside of school. Do not include volunteer work and employment in this section, as there are designated sections entitled Community and Volunteer Experience and Employment. We do not want duplicate entries. In order of importance, list the extracurricular activities that you have found to be the most meaningful during your high school years. We understand there may not be enough space to list all of the activities in which you are involved, or that you may not have a total offive. Most Meaningful Activityf? roup Na me: Category: Please Select Briefly describe the activity. Word count: 0 out of 20 max Why did you choose to participate in this extracurricular activity? {choose best answer] Please Select What did yeu de while in this greup er club? [cheese best answer} Please Select II- Grade levels participated: 9D 10D 11D 12D Were yeu in a leadership pesitien? Yes}: Nel:l lfyesleader? {cheese best answer} Please Select Secend Mest Meaningful Activitny reu Na me: Categery: Please Select Briefly describe the activity. Werd ceunt: eut ef 20 max Why did yeu cheese te participate in this extracurricular activity? {cheese best answer} Please Select What did yeu de while in this greup er club? [cheese best answer} Please Select Grade leyels participated: 9D 10D 11D 12D Were you in a leadership position? ?r?esD Nel:l If yesleader? [cheese best answer} Please Select Third Most Meaningful Actiyityf? reu Na me: Categery: Please Select ?ll' Briefly describe the activity. Werd ceunt: put of 20 max Why did you cheese to participate in this extracurricular actiyity? {cheese best answer} Please Select What did you do while in this greup er club? [cheese best answer} Please Select Grade leyels participated: 9D 1eD 11D 12D Were yeu in a leadership pesitien? Yes}: lfyesleader? {cheese best answer} Please Select II Feu Mest Meaningful Activityf? reu Na me: Categery: Please Select II Brie?y describe the actiyity. Werd ceunt: eut cf 20 max Why did yeu cheese te participate in this extracurricular actiyity? [cheese best answer} Please Select II What did yeu de while in this greup er club? {cheese best answer} Please Select Grade leyels participated: 9D 10D 11D 12D Were yeu in a leadership pesitien? ?Y?eslj If yesleader? {cheese best answer} Please Select 1h Fifth Mest Meaningful Activity/G reu Na me: Categery: Please Select {h Briefly describe the activity. Werd ceunt: eut of 20 max Why did yeu cheese te participate in this extracurricular activity? [cheese best answer} Please Select 1h What did yeu de while in this greup er club? [cheese best answer} Please Select {h Gracie levels participated: 9D 10D 11D 12D Were yeu in a leadership pesitien? ?Y?eslj If yesleader? {cheese best answer} (?Ill-J. Please Select Sax-e a ed Next Page See fer r'v'1iesing ?an swere Going to College Required The Daniels Scholarship Program provides a four?yearI annually renewable college scholarship. Daniels Scholarships may be used at any accredited two? or four?year nonprofit college or university in the United States. Students must intend to complete a bachelor's degree. The Daniels Fund strongly encourages you to apply to college by the end of December 2019. In order of preference, list the colleges andr'or universities to which you have already applied or intend to apply. You are required to list at least two colleges or universities. In addition, please provide the most important reason this school is among your choices. lfyour college does not appear in this list or if you have applied to or plan to apply to more than three schools, list those additional schools in the text box below. Please note that the Daniels Scholarship can only be used at one of the schools you list below. College or University] State: .1 Please Select . College or University Name: Peason: II Please Select College or University 2 State: Please Select College or University Name: Peason: Please Select 1h College or University 3 State: .I. Please Select . College or University Name: Peason: Please Select 1h- List any additional colleges to which you have applied or will apply, including city and state. Please remember that the Daniels Fund can only provide scholarship funding at nonprofit accredited colleges or universities in the United States. The Daniels Scholarship cannot be used at any for?profit institution. Word count: 0 out of 200 max Graduation rates are an important factor in choosing which college you would like to attend. Follovvr this link NCES College Navigator and use the provided instructions, to lookup and enter the most recent four?year graduation rates at the colleges or universities you selected in "College or Universityl't "College or University and "College or University Do not supply graduation rates for any additional colleges. College or Universityl Four?Year Graduation Rate: College or University 2 Four?Year Graduation Rate: College or University 3 Four?Year Graduation Rate: Have you reviewed the career placement rates for all ofthe collegesfuniversities where you are planning to apply? Yes No Getting to know you Please select the answer that best indicates hovv much you agree or disagree based on a "typical" situation: People would say I keep my word. .I. Please Select I pay a lot of attention to how I feel. II- Please Select I take risks. Please Select Problems will not happen in college. .I. Please Select Because of my background, I sometimes feel that people should give me a break. Please Select I lead by example. Please Select My feelings are clear to me in any giyen moment. Please Select I can see myself owning my own business. Please Select I really don?t know what I want to study. Please Select I am sometimes looked up to by others. Please Select . Eyeryone should get an automatic raise after a year of working. .I. Please Select . I ?lose it? in stressful situations. II- Please Select I'm okay telling little white lies. .I. Please Select . I know what I want to be doing ten years from now. Please Select find different ways to apply what We learned. .I. Please Select . I am good at convincing others to see things my way. Please Select I am not good at getting others to go along with me. Please Select . I meet deadlines. Please Select I am often surprised by others' reactions to what I sayfdo. .I. Please Select . lam proud to be an American. Please Select i have tall-ted about my career goals with someone who has worked in that field. Please Select i lam comfortable interacting with people different from me. Please Select Government should decide how business profits are distributed. .I. Please Select have difficulty making sense out of my feelings. .I. Please Select . I don't feel much of an attachment to the USA. 1h Please Select I usually wait as long as possible before doing work. .I. Please Select Same a nd f-Jez-tt Page Scan for issi ng An swer. High School Peguired Are you currently home?schooled? Yes ig School Counselor's Information First Name: Last Name: Phone: Email: Please check this box if you do not authorize the Daniels Fund to update your high school counselor on the status of your application completion periodically throughout the selection process: I do not authorize What is the highest math class you have completed or are currently enrolled? Please Select ACTISAT Scores Which exams have you taken? ACT SAT ACT What did you score on the ACT test? If you have taken the ACT test multiple times, provide scores for the test with the highest composite score on which you also met our eligibility subscore requirement of 18 or higher. All scores must be from the same test date superscoring is not allowed. You will be required to upload your ACT test scores to verify the scores entered below before submitting your application. Com posite: English: Math: Reading: Science: Writing [iftaken}: SAT What did you score on the SAT test? If you have taken the SAT test multiple times, provide the highest combined Evidence?Based Pleading and Writing and Math score, and individual section scores below on which you also met our eligibility subscore requirement of 490 or higher. All scores must be from the same test date su perscoring is not allowed. You will be required to upload your SAT test scores to verify the scores entered below before submitting your application. Combined Evidence?Based Reading and Writing and Math: Math: Evidence?based Reading and Writing: AP. IE. or dual enrollment Classes Does your school offer [check all that apply]: Advanced Placement classes International Baccalaureate program Dual enrollment in college Other programs that enables students to earn college credit Have you enrolled in AP. IE. or dual enrollment classes {select no. if not offered]? ?Yes No lfyes. how many AP. IE. or dual enrollment classes have you completed? How many AP. IE. or dual enrollment classes are you currently taking? Getting to know you Please select the answer that best indicates how much you agree or disagree based on a "typical" situation: I am confident that I can graduate in 4years or less. Please Select i Differences in social standing are an incentiye to work harder. Please Select i Usually, I need to be asked to take on a task around the housefschoolfwork. .I. Please Select Peceiying praise embarrasses me. .I. Please Select . On my own. I have done research onjobs I could get with my intended major. .I. Please Select . I probably won't be able to pay for my children to go to college. Please Select i I try to improye my weaknesses. Please Select i I plan on owning my own home. .I. Please Select . Government should guarantee jobs for everyone. Please Select i I know when to speak and when to listen. Please Select i (line is able to live well in America. 1h Please Select Government is responsible for meeting all our needs. Please Select i In college. I will seek help with my study skills if I fall behind. .I. Please Select . My friends look to me to make decisions. .I. Please Select . Dne's own efforts don't count. Please Select . Dealing with stressful situations often causes me to lose sleep. .I. Please Select . Differences in social standing are acceptable. .I. Please Select . The economic system in the United States is rigged. 1h Please Select If I'm 5?10 minutes late. that's OK. 1h Please Select I am good at managing deadlines. .I. Please Select . I look forward to meeting people different from me. .I. Please Select I would consider myself to be ambitious. 1h Please Select I know when I?m losing control of my emotions. 1h Please Select People can depend on me. Please Select i Sat-re a nd Next Page Scan for issi n11. an sen Household and Family Responsibilities Required Think about your home responsibilities, such as caring for relatiyes, doing maintenance, household paperwork, tutoring siblings, household chores, etc. Please do not include any paidfunpaid ranch or farm work in this section. You can include paid andfor unpaid ranch or farm work in the employment section ofthe application. Responsibility 1 Description of Responsibility: 1: Category: Please Select II- Responsibility 2 Description of Responsibility: Category: Please Select Responsibility 3 Description of Responsibility: Categ ory: Please Select 1h Understanding Your Preferences Which image evokes the strongest positiye emotion? Db IE IS USED IE Getting to know you Please select the answer that best indicates how much you agree or disagree based on a "typical" situation: I keep to myself pretty much. Please Select I check important work carefully before turning it in. Please Select i I keep my word. 1h Please Select I won't make a move when I'm uncertain. 1h Please Select Usually, I can wait patiently for my turn. Please Select i yell at people when they are driying and cannot hear me. Please Select i In groups where I am comfortable I am often looked to as the leader. Please Select i then, I "think? with my heart first. .I. Please Select My friends think have great ideas. .I. Please Select I know where to draw the line with my friends. .I. Please Select I don't expect to be inyolyed with any campus groups. Please Select . I expect someone will giye me money to buy books every year. 1h- Please Select People would say that when I make a promiser I keep it. Please Select find that most people are depressing. Hi Please Select I think it's good for eyeryone to haye fixed values. 1h- Please Select I control my urges to oyerindulge. Please Select Saye a nd Nest Page Scan for issi :1 an sen Pa rentls) or Legal Qua rdianls} Information Required For purposes of this section, Parentls] are defined as your parentls}, legally adopted parentls], stepparent, or any other legal guardianls] with whom you currently live in your primary household. Parent or Legal Guardian Relationship: Please Select 1h- First Name: Last Name: Er'nail: Home Phone: Cell Phone: Parent or Legal Guardian Relationship: Please Select First Name: Last Name: Email: Home Phene: Cell Phone: Save a nd Next Page Sea fer i'v-i iesi Hg ?an swer'e References Required You have already been asked to identify a recommender from your high school who can provide information about you based on the Daniels Scholarship Program criteria. Please proyide the names and contact information for two additional people we may speak with, rfnecessary, about your candidacy for the Daniels Scholarship Program. References can be people from your school, an employer, community leader, mentor, coach, scoutrnaster, community service coordinator, religious leader, etc. These people must be at least 21 years of age and cannot be related to you. 1'l'our references are not required to submit anything in writing to the Daniels Fund and they should not include your recommender. Reference 1 First Name: Last Name: Drganization: Job Title: Email: Phone: Relationship to you: Please Select 1h- Reference 2 First Name: Last Name: Organization: Job Title: Email: Phone: Pelationship to you: Pleaee Select a had Next Page Sea fer i?u -J Si ?an ewe re II- Short answer Questions Required Please respond to the questions below in a vvay that vvill provide insight into your personal characteristics, abilities, achievements, motivation, and potential. We ask that your responses be as specific as possible. Your attention to detail and your motivation to succeed are also demonstrated through your correct use of grammar and spelling. Please take the time to carefully proofread your ansvvers and avoid using abbreviations, slang, or "testing" language. We recommend that you save your ansvvers in a Word document or similar for your future reference. 1. Tell us about your future self. What dreams do you have for your future? What plans have you made to accomplish your dreams? 4: Word countyou believe is ultimately more responsible for making things better: individuals, businesses, nonprofits, or government? If you believe all are equally responsible, what role should each play? Word count: out of 500 max 3. In today's political landscape, there is a good amount of debate about capitalism and socialism1 and the merits ahdfor drawbacks of each. Create an essay around this to bic. Word count: Ci out of 500 max Sat-re a hd Next Page Sca for issi rig eh se rs Representations and Permissions Required Disciplinary History Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from 9th grade to the present, whether related to academic misconduct or behavioral misconduct, which resulted in your probation, suspension, removal, dismissal, or expulsion from the institution? Yes : Nolj Do you have any pending hearings for a disciplinary violation at any educational institution you have attended from 9th grade to the present, whether related to academic misconduct or behavioral misconduct, which could result in your probation, suspension, removal, dismissal, or expulsion from the institution? Yes No Have you ever been convicted of a misdemeanor, felony, or other crime?? Yes No Do you have any pending criminal charges against you? Yes No Have you ever been fired from ajob? Yes No If you answered "yes" to any of the above five questions, or believe there are other disciplinary matters the Daniels Fund should be aware of, please explain the circumstances below and tell us what you learned from the experience. These incidents will be considered and may or may not disqualify applicants. Word count: out of 250 max Acknowledgements To the best of my knowledge. the information contained in this application is true and accurate. I understand that the Daniels Fund reserves the rig ht to verify any information that I have reported or otherwise disclosed in this application. I understand that any false. inaccurate. or undocumented information may lead to the declination of my application or the revocation of my scholarship in the event I am selected as a Daniels Scholar. ?r?es I affirm that the answers I gave to the short answer questions are my original work. ?r?es have read and agree to the Daniels Fund Terms of Service and Dnline Privacy Policy. ?r?es I understand that the Daniels Fund may wish to use my name. image. likeness, or speech in an audio or video recording. film. or photograph in connection with any business activity of the Daniels Scholarship Program. I hereby give my permission to the Daniels Fund to use my name. image. likeness. or speech. ?r?es No I understand that the Daniels Fund may respond to other nonprofit educational entities such as colleges. universities. and other scholarship providers who have a desire to contact me about additional educational or scholarship opportunities. I hereby give my permission to the Daniels Fund to share the following information with such entities: my name. my high school. my college choices. and my email address. ?r?es No I authorize the Daniels Fund to send text messages to my cell phone. I understand that text messaging rates will apply to any messages received from the Daniels Fund. I also understand that I or the Daniels Fund may revoke this permission in writing at any time. I agree not to hold the Daniels Fund liable for any electronic messaging charges or fees generated by this service. I further agree that in the event my contactr'cell phone number changes that I will inform the Daniels Fund. ?r?es No Technical Survey Did you hate any technical difficulties with this application? Yes No Technical difficulty with {check all that apply]: Emails Logging in Adding a recommender Saying information Site navigation Website speed Finding internet access Color scheme Font size Scanning for missing answers Progress bar Submission Document uploads Timing out Copying and pasting Knowing where was in the process Please describe any technical difficulties: How many hours did the entire application process take you? Please Select db Submit Application Pequired You are able to work on your application until the deadline. The application does not need to be completed in one session; it can be saved and resumed later. You will only be able to submit the application once all required questions have been answered. When you are ready, and all questions have been answered, click the Submit Application button. Please note, clicking the Submit Application button is the final step in completing your application. Your recommender must also submit their recommendation by November 15, 2019 at 4:00 p.m. MST for you to be considered for the Daniels Scholarship Program. Editing a Submitted Application The need may arise for you to edit your submitted application. Edits will be allowed until the application deadline. You can re?open and make edits to an already submitted application. However, you will need to click the Submit Application button again to resubmit your application. Edits will not be accepted after the application deadline has passed. Please note, ifyou reopen your application, it will have a status of "in progress" until you click the Submit Application button again. Once you click the Submit Application button you will be notified by email that your application has successfully been submitted. it Application