Return by April 1
HEALTHY COMMUNITY INITIATIVE
(Hawarden-Chatsworth-Ireton)
This scholarship has been established by HCI to be awarded annually to two West Sioux Seniors. This scholarship will be for two $250 gifts each year. These gifts will be presented after the successful completion of one semester of higher education. For consideration, please complete and return this form to your school counselor by April 1. The winners will be announced at your school's commencement exercises.
Candidates for this scholarship must have met as many as possible of the following 40 Developmental Assets needed to be healthy, caring and responsible:
|
External Assets |
Internal Assets |
|
Support |
Commitment to Learning |
|
*Family support |
*Achievement motivation |
|
*Positive family communication |
*School engagement |
|
*Other adult relationships |
*Homework |
|
*Caring neighborhood |
*Bonding to school |
|
*Parent involvement |
*Reading for pleasure |
|
Empowerment |
Positive Values |
|
*Community values youth |
*Caring |
|
*Youth as resources |
*Equality and social justice |
|
*Service to others |
*Integrity |
|
*Safety |
*Honesty |
|
Boundaries and Expectations |
*Responsibility |
|
*Family boundaries |
*Restraint |
|
*School boundaries |
Social Competencies |
|
*Neighborhood boundaries |
*Planning and decision making |
|
*Adult role models |
*Interpersonal competence |
|
*Positive peer influence |
*Cultural competence |
|
*High expectations |
*Resistance skills |
|
Constructive Use of Time |
*Peaceful conflict resolution |
|
*Creative activities |
Positive Identity |
|
*Youth programs |
*Personal power |
|
*Religious community |
*Self-esteem |
|
*Time at home |
*Sense of purpose |
|
|
*Positive view of personal future |
PLEASE COMPLETE THE FOLLOWING:
Name_______________________________________________________________________________
College or Trade School you plan to attend:
____________________________________________________________________________________
Area of Study:________________________________________________________________________
*Please write a short essay, telling us about one of the 40 Assets and how it has helped you in your life's journey. Please describe how you will impact the community you live in, in the future, by attaining this asset.
*Please attach a copy of your resume.
*Give one reference (not a relative) than can verify the asset you described.
Name of Reference:_____________________________________________________________________
Phone Number:________________________________________________________________________
Best time to contact this person:___________________________________________________________
Your Signature:_______________________________________________Date:_____________________
Your signature serves as a release which allows the HCI committee to contact this person.