Application For Academic Year 2008-09 
  
Applicant's Name:_________________________________________	

Applicant's Home Email:____________________________________

Permanent Address:________________________

City:___________________State:_______Zip:_________	

Area Code & Phone: (_____)     __________________

College Choice:____________________	High School:____________________	

Test Scores, Grade Point Average

S.A.T. Scores:  Reading:______ Math:______ Writing:______ or ACT Composite Score:_____

Cumulative High School Grade Point Average (4.00 Scale):________________________	

Class standing in high school (example: 4th/400):_______________________________	


Honors and Awards
Briefly describe significant scholastic distinctions or honors you have won, 
beginning with ninth grade.











	
			
Extracurricular, Personal and Volunteer Activities
List your principal extracurricular, community and family activities and hobbies
in the order of their importance and interest to you. Place an asterisk (*) 
by those that were associated with or sponsored by your school. 
Please complete this section even if you attach a résumé.
Activity Avg. hours per week Weeks per year Grade Level(s) Position held, honors won,
or letters earned
         
         
         
         
         
         
         
         
         


Work Experience
List jobs you have held (including summer jobs) during the last three years.

Specific nature of work Employer Approx. dates of employment Approx. number of hours worked per week
       
       
       
       
       


Personal Statement
Write an essay that will help us to have a better understanding of who you are as a person and a student and that will demonstrate your ability to organize your thoughts and express yourself. Please type your essay of approximately 250 to 500 words on a separate sheet of paper and submit it with your application. Please choose ONE of the following topics:
  1. Evaluate a significant experience, achievement, risk you have taken or ethical dilemma you have faced and its impact on you.
  2. Discuss an issue of personal, local, national or international concern and its importance to you.
  3. Indicate a person who has had a significant influence on you and describe that influence.
  4. Describe a character in fiction, an historical figure, or a creative work (such as art, music, science, etc.) that has had an influence on you and explain that influence.
Required Additional Information
The application requires the following additional information:
  1. An official, certified High School transcript.
  2. Certification of SAT/ACT scores, if not included on high school transcript.
  3. Financial Aid Worksheet (to be completed by each College or University).

Send the original application, your Personal Statement and items A. and B. of the Required Additional Information to The Edmund F. Maxwell Foundation. Send a copy of the first page of this application form together with a blank C. Financial Aid Worksheet to each institution for which the applicant is seeking financial aid. Each institution must send the completed Financial Aid Worksheet to The Edmund F. Maxwell Foundation together with a copy of the first page of this application form.

Selection will be made without regard to the applicant’s race, color, ethnic origin, religious belief, sex, marital status or physical handicap, in accordance with Title IX of the Educational Amendments, and with section 504 of the Rehabilitation Act of 1973.

I certify that this information is true, complete and accurate. I authorize release of information to confirm and/or verify this application. I further authorize release of my name in connection with announcements of scholarship awards in the event that I am selected to be a Maxwell Scholar.

Applicant's Signature:_____________________________________

Date:______________________________

For Academic Year 2008-09

The Edmund F. Maxwell Foundation
Post Office Box 22537
Seattle, Washington 98122-0537
http://www.maxwell.org
admin@maxwell.org