“Elsie Jepson Educational Award”
Presented by: Ken-Ton Friends of Youth Foundation, Inc

DUE NO LATER THAN April 30, 2008

The “Elsie Jepson Scholarship Award” was established in March 2005 to
honor the memory and spirit of Elsie Jepson, Ken-Ton Schools Pupil Services
Administrator for over 52 years and a tireless champion for children’s rights –
especially those with special needs.

Friends of Youth Foundation, Inc. - Officers
Robert W. Wunsch Jr. – President
Timothy Doolittle – Vice President
Brian O’Bannon – Secretary
Edward J. Mrozinski – Treasurer
Dennis Gallagher – Chairman “Elsie Jepson Educational Award” Committee

Purpose: The purpose of this educational grant is to give financial assistance
to individuals classified by the Committee on Special Education
who are continuing their education or to Individuals going to school
for Special Education training. This educational award may be used
for tuition, fees, supplies to continue your education, uniforms, etc.

Awards: The amount of the award will be up to $500.00 based on the
committee’s recommendation.

Criteria that the committee will consider include:
• Nominee should be a Senior or in their last year of school at time of applying
• Community Service involvement /ability to assist others
• Plans for continued education or training
• Commitment to success
• Letter of recommendation from a current instructor
• Must be a Ken-Ton resident

Apply: To apply for the Elsie Jepson Award:
• Fill out the application on next page
• Attach a letter of recommendation from a current instructor

Deadline: All material must be received by April 30, 2007
Send the completed attached form and letter of recommendation to:

Contact: Dennis Gallagher (716) 361-5764
Ken-Ton Friends of Youth
P.O. Box 607
Kenmore, NY 14217

 Recommendation Form - "Elsie Jepson Educational Award"

 
  Nominee's Name:________________________________________________________________
  Address:_______________________________________________________________________
 _______________________________________________________________________________
 Phone:_________________________  Date of Birth:___________________________
  School: _______________________________________________________________________
  Year/Grade:_______________

Recommended By: Name: ______________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________________
Phone: ____________________________________________________________________
Parent(s)/Guardian(s) Name: _____________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________________
Phone: ____________________________________________________________________

 

 

 

 

 


 Recommendation Form - "Elsie Jepson Educational Award"

 Nominees's Name: ________________________________________________

What are your educational/vocational goals & plans for the future?

___________________________________________________________________________________
 
___________________________________________________________________________________

 ___________________________________________________________________________________
 
___________________________________________________________________________________

___________________________________________________________________________________
 
__________________________________________________________________________________
 
___________________________________________________________________________________
 
___________________________________________________________________________________
 
___________________________________________________________________________________
 
___________________________________________________________________________________

___________________________________________________________________________________

 ___________________________________________________________________________________
 
___________________________________________________________________________________
 
__________________________________________________________________________________
 
___________________________________________________________________________________


____ Check if additional pages are attached.


  Recommendation Form - "Elsie Jepson Educational Award"

 Nominees's Name: ________________________________________________

How do you plan to reach your goals?

___________________________________________________________________________________
 
___________________________________________________________________________________

 ___________________________________________________________________________________
 
___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________
 
___________________________________________________________________________________
 
Explain what community service you have completed or how you have been helpful to others?
 
___________________________________________________________________________________
 
___________________________________________________________________________________

___________________________________________________________________________________

 ___________________________________________________________________________________
 
___________________________________________________________________________________
 
__________________________________________________________________________________
 
___________________________________________________________________________________


____ Check if additional pages are attached.

  Recommendation Form - "Elsie Jepson Educational Award"

 Nominees's Name: ________________________________________________


___________________________________________________________________________________

___________________________________________________________________________________
 
___________________________________________________________________________________

 ___________________________________________________________________________________
 
___________________________________________________________________________________

___________________________________________________________________________________
 
___________________________________________________________________________________
 
___________________________________________________________________________________
 
___________________________________________________________________________________

 

 Please Return The Completed Original Form and 4 copies To:

Ken-Ton Friends of Youth Foundation, Inc.
P.O. Box 607
Kenmore, N.Y. 14217

- Due No Later Than April 30, 2008 -

 
For more information on the
Ken-Ton Friends of Youth Foundation, Inc.
please visit our web site at:


www. kentonfriendsofyouth.org