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NEW OUTLOOK PIONEERS JOE CLERES MEMORIAL SCHOLARSHIP APPLICATION FOR STUDENTS WITH DISABILITIES - 2013 PURPOSE Financially to assist physically or mentally challenged students. mentally challenged student or by someone on their behalf* Each financial award is to be used solely for tuition support. Payment of the scholarship award will be made directly to the school that will provide the education for the physically or mentally challenged student. Only completed applications will be considered* Applicants must be qualified residents of the U*S* and attending an education institute in the U*S* Email address Student Name Print name social security number area code telephone number Complete Street Address City State Zip Code Nature and Severity of Disability Qualified resident of U*S* Estimated tuition cost per year Annual cost to student excluding tuition Other financial support already awarded to the applicant Please identify the grade you will enter in the fall --SUPPORTING DOCUMENTATION A one-page essay describing how the applicant has met the challenge of his/her disability is required* A description of the severity of the disability must be included in the essay. One additional page of supporting documentation may be submitted* No more than one page 8 by 11 of supporting documentation in addition to the one page essay will be considered* Photographs audio or videotapes display materials films or scrapbooks should not be submitted as they will not be considered in judging the nomination* All submitted materials become the property of New Outlook Pioneers Group 18 and awards are at the sole discretion of the Pioneers. Note to prior year applicants previous applications will not be reviewed so it is important to include all information even if previously provided on prior applications. Applications must be postmarked by March 11 2013 and mailed to NewOutlook Pioneers c/o New Outlook Pioneers Joe Cleres Scholarship Program Attn Debbi Althoff 1801 California Street 44th Floor Denver CO 80202. mentally challenged student or by someone on their behalf* Each financial award is to be used solely for tuition support. Payment of the scholarship award will be made directly to the school that will provide the education for the physically or mentally challenged student. Payment of the scholarship award will be made directly to the school that will provide the education for the physically or mentally challenged student. Only completed applications will be considered* Applicants must be qualified residents of the U*S* and attending an education institute in the U*S* Email address Student Name Print name social security number area code telephone number Complete Street Address City State Zip Code Nature and Severity of Disability Qualified resident of U*S* Estimated tuition cost per year Annual cost to student excluding tuition Other financial support already awarded to the applicant Please identify the grade you will enter in the fall --SUPPORTING DOCUMENTATION A one-page essay describing how the applicant has met the challenge of his/her disability is required* A description of the severity of the disability must be included in the essay.

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