The Star Student Scholarship of Iowa

scholarship logo 2

ClaimAid Consulting Corporation and the IASB are offering a $2,000 one-time grant award for a graduating special education senior who is planning to attend college. This scholarship will be awarded based on a number of requirements. The applications will be reviewed by members of IASB and ClaimAid Consulting Corporation. The scholarship committee will focus on the student’s educational goals and their accomplishments in academia thus far. In addition to academia, the committee will review any involvement in extracurricular activities or community involvement. Applicant must attend a high school in a school district that participates in the Iowa Medicaid Reimbursement Program (IMED) and is a participant at the time the scholarship is awarded.

There are six sections of the Star Student Scholarship of Iowa. Each section must be completed and all questions must be answered fully and honestly, not exceeding the space provided. If you are unable to answer a question, please fill in the space with a Not Applicable sign (N/A). Failure to complete the application will result in termination. If you have any questions, please contact ClaimAid Consulting Corporation at (317) 777-7539.

To apply, complete the application below and submit by January 15th, 2018:

1. Demographic Data

First Name

Middle Initial

Last Name

Date of Birth (required)

Street Address

City

State

Zip Code

Contact Phone

Contact Phone Type

Your Email (required)

2. Personal Aspirations

Describe your future academic goal(s).

Describe your career goal(s).

Please write a paragraph about a person who made a significant difference in your life.

3. Schooling (current and future)

Current High School

Current School District

Cumulative GPA:
on a scale of:

I am a senior in high school
YesNo

Date of graduation (required)

I have applied to college
YesNo

I have been accepted to college
YesNo

What graduate degree do you plan to pursue?

4. Involvement in Programs and Activities

Please provide no more than five (5) programs and/or activities you have been involved in either inside or outside of your high school. Please list in descending order of significance. It is acceptable to leave lines blank in the event that there are no more activities to record.

Please Include "Name", "Description" and "Dates Participated" for each.

1.

2.

3.

4.

5.

5. Awards and Recognition

Please provide no more than five (5) awards or recognitions you have been given either inside or outside of your high school. Please list in descending order of significance. It is acceptable to leave lines blank in the event that there are no more awards or recognitions to record.

Please Include "Name", "Description" and "Provider" for each.

1.

2.

3.

4.

5.

6. Teacher/Counselor Data

This section is for the individual who helped the special education student complete this application.

Name of Counselor

Contact Phone

Counselor Email

Signature (Please type full name again to sign)

Date this form was completed

captcha

To validate this form, please type the above code here:

Mailing Address:

ClaimAid
8141 Zionsville Rd
Indianapolis, IN 46268
Attn: IA Schools Scholarship