THE P. G. & RUBY RUSH HOLLANDSWORTH PERPETUAL SCHOLARSHIP

Only available for stud ents attending a PRIVATE College/University in WV

APPLICATION DEADUNE IS APRIL 15

> Background. P. G. & Ruby Rush Hollandsworth were residents of Clarksburg, WV prior to their death. At their direction a perpetual scholarship was established at Bank One, Private Client Services, now known as JPMorgan . 2005 was the first year for the scholarship and four scholarships were awarded. Please note that the number of scholarships awarded may vary from year to year.

> Purpose. The purpose of the P. G. & Ruby Rush Hollandsworth Perpetual Scholarship is to provide scholarships to qualified students who have successfully completed high school and desire to obtain a post-secondary education at an accredited private college or university in the state of West Virginia. We welcome applications from students with a physical impairment, as defined by the federal Americans with Disabilities Act as in effect at the time the scholarship award is made. Scholarship is open to all students meeting guidelines below and not limited to students with physical impairments. Financial need will also be a consideration in the selection of the scholarship recipients. Scholarships are ava ilable for new graduates and also for renewals for prior recipients.

> Selection Committee. As provided in the governing document, the Selection Committee is to consist of three members, one of whom shall be a member of the Clarksburg Baptist Church, one of whom shall be a child of P.G. and Ruby Rush Hollandsworth , and the third of whom shall be the Trustee. The selection Of the scholarship recipient(s) shall be made in the absolute discretion of the Selection Committee.

> Guidelines. The followinq quidelines have been established by the Selection Committee:

1. Applicants must be graduates of high schools located in: BARBOUR, DODDRIDGE, HARRISON, LEWIS, MARION & TAYLOR Counties, WV

2. Applicants must have a minimum secondary education GPA of 3.0.

3. Applicants must have applied for admission to an accredited PRIVATE college or university in the state of West Virginia (l.e, Alderson Broaddus or WV Wesleyan).

4. For the purposes of this scholarship, the term "physical impairment" shall be defined as such term is defined by regulations promulgated pursuant to the federal Americans with Disabilities Act as in effect at the time the scholarship award is made.

5. Financial need will be considered in the selection of the scholarship recipients.

6. The scholarships are renewable for the sophomore, junior and senior years provided that the recipient:

a) Maintains a minimum post-secondary education GPA of 3.0. b) Reapplies to JPMorgan each year by April 15 and submits proof of the

minimum 3.0 GPA in the form of a grade transcript.

7. Applications must be postmarked by April 15.

J.EMorgan 1-2007

> Financial Need" Defined. In determining whether an applicant for a scholarship from said "Trust" qualifies under the provision regarding "financial need", the Committee considers the fact that "need" is a wholly relative term, the conception of which must, within reasonable limits, vary with the personal situation of the individual making application for such scholarship.

Therefore, in determining "financial need" of the applicant, the committee is authorized, in its absolute discretion, to take into account the anticipated income of the applicant and the financial status of the parents of the applicant. However, other factors, such as the number of children in the family of the applicant, the number of children that one family has in college at the same time, etc. may be taken into account by the Committee.

ANY OUESTIONS?

Please contact:

Cory Whitlock, Scholarship Administrator JPMorgan

Telephone: 214-965-2874 Fax: 800-883-7695

Mail completed application to:

JPMorgan Private Client Services P. G. & Ruby Rush Hollandsworth Perpetual Scholarship P.O. Box 227237 Dallas, TX 75222-7237

APPLICATION MUST BE POSTMARKED BY APRIL 15 JPMorgan is not responsible for items lost in the mail.

The applicant bears all responsibility to ensure that JPMorgan timely receives this application.

Incomplete applications WILL NOT be considered

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1·200 7 2 J.EMorgan

P. G. & RUBY RUSH HOLLANDSWORTH PERPUTUAL SCHOLARSHIP APPLICATION

Onlv available for students attending a PRIVATE College / University in WV

J.EMorgan

APPLICATION DEADLINE IS APRIL 15

o First Time Applicant o Reapplication

1. Name (Last) (First) (Middle) Preferred Name

Street City County State Zip

Telephone No. Social Security No. Sex Date of Birth

e-mail address Driver's License or lD # Marital Status

2. Father's or Guardian's Name

Address Phone No.

Father's or Guardian's Occupation

Employer _ Phone No.

Employer's Address

Mother's or Guardian's Name

Address Phone No.

Mother's or Guardian's Occupation

Employer _ Phone No.

Employer's Address

3. List other dependent family members in the same household, their relationship to you and their ages . Indicate if they are employed full-time. If they are students, list the name of the school they attend and the year they are in.

4. State name of PRIVATE college or university for which the scholarship is being requested. List the anticipated subject area. (NOTE : If awarded, scholarship checkwill be madepayable to the college/university)

Private College/University

Accredited - Yes (

Will live on Campus (

No ( Accepted (

Will live off Campus (

City, State

Acceptance Pending (

Will Commute from Home (

Subject Area

Enrolled (

1-2 007 1

5. Schools attended (ninth grade through present)

Name of School Dates Attended

Name of School Dates Attended

Name of School Dates Attended

6. High School Graduation Date

# of Students in Class Rank in Class High School GPA (H.S. seniors must attach transcript)

ACT Score SAT Score Other

7. Present Year in College Cumulative GPA (college students must attach transcript)

8. List membersh ip and participation in school organizations and activities. Specify any positions of leadership. Please do not abbreviate organization and/or club name(s). (Attach a separate sheet if necessary)

9 . List membership and participation in community, civic, and religious organizations and activities. Specify any positions of leadership. Please do not abbreviate. (Attach a separate sheet if necessary)

10. List any honors awarded. (Attach a separate sheet if necessary)

11. List any work experience. (Attach a separate sheet if necessary)

Employer Phone No. Dates - From/To Position

Employer Phone No. Dates - From/To Position

1·2007

Employer Phone No.

2

Dates - From/To Position

12. List any scholarships, grants and loans you are seeking or have been awarded.

Source Amount Sought/Received Granted Pending

Source Amount Sought/Receiv ed Granted Pending

Source Amount Sought/Receiv ed Gran ted Pending

Gran ted Pending Source Amount Sought/Received

13. Where do you expect to obtain funds for school?

Scholarships Parents Part- Time Work Loans Other

14. List Family Income:

15. YOU MUST ATTACH ONE OF THE FOLLOWING FOR INCOME VERIFICATION:

(1) Completed copy of your current year FAFSA (Free Application for Federal Student Aid) OR

(2) SAR (Student Aid Report) for current year OR

(3) Your parent 's income tax return for prior year.

16. Please state any unusual family or personal circumstances you feel warrant the attention of the selection committee. (Attach a separate sheet if necessary)

17. If applicable, please state any physical impairment. For the purposes of th is scholarship, the term "physical impairment" shall be defined as such term is defined by regulations promulgated pursuant to the federal Americans with Disabilities Act as in effect at the t ime the scholarship award is made . (Attach a separate sheet if necessary)

18. Please list by name & relationship, any member of your immediate family who is employed by Bank One or JPMorgan:

3 1-2007

By signing below, the student affirms that this informat ion is accurate & complete to the best of his/her knowledge, and that prov iding false or misleading information may result in revocation of any scholarship award.

Further, by signing and submitt ing an applicat ion to a scholarship trust for which JPMorgan, is trustee or agent, the applicant agrees that JPMorgan, may release any and all confidential information on this application to those individuals (previously identified on this application) whom JPMorgan reasonably believes are the parent and/or guardian of said applicant, unless the applicant specifically notifies JPMorgan, in writing that such individuals may not have access to confidential information.

In addition, by signing and submitting an application to a scholarship trust for which JPMorgan, is trustee or administrative agent, the applicant hereby agrees that JPMorgan shall have access to the applicant's confidential information in the possession of the postsecondary school at which applicant is expected to enroll (or actually enrolled) in order to verify proof of enrollment, grades, or any other information relevant to this application .

Student's Signature Student's Printed Name

Date

REMEMBER ­ Mail Completed Application To:

1. This scholarsh ip is ONLY available for students attending a JPMorgan Private Client Services PRIVATE College/University in West Virginia . Nonprofit and Charitable Account Administration

2. Provide ALL requested information. P.G. & Ruby Rush Hollandsworth I f question is not app licable to you, ind icate so by wr iting "N/A". Perpetual Scholarship

3. ATTACH applicable Grade Transcript P.O. Box 227237 4 . ATTACH Verification of Income (see question # 15) Dallas, Texas 75222-7237 5. Applicat ion must be postmarked by April 15

Any Questions? Please Conta ct Cory Whitlock at 214- 965-2 874

lPM organ is not resp onsible for it ems lost in the mail. The applicant bears all responsib il ity to ensur e that lPM organ timely receiv es this application .

6. Incomplete applications will NOT be considered.

4 1-2007

P.G. & RUBY RUSH HOLLANDSWORTH PERPETUAL SCHOLARSHIP

Statement of Receipts VS. Expenses

Receipts (student) - List sources and amounts of income available to you for educational expenses.

Savings (Current or potential)

Employment

Parental or other contribution

Grant(s)/Scholarship(s)

Loans

Other (Please explain below)

TOTAL RECEIPTS $

Expenses ­ List anticipated expenses for the full year.

Tuition

Room & Board

Books & Supplies

Fees

Miscellaneous (Please explain below)

TOTAL EXPENSES $--'---------- ­LESS TOTAL RECEIPTS (above) $----'----------- ­NEEDED (SHORTFALL) ~$===============

In the space below, please indicate the source and amount of loans, grants, and scholarships which you received the previous school year, if applicable.

APPLICATION MUST BE POSTMARKED BY APRIL 15TH

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1-2007 5

P.G. & RUBY RUSH HOLLANDSWORTH PERPETUAL SCHOLARSHIP

COUNSELOR SHOULD PLACE THIS PERMISSION NOTICE IN STUDENT'S FILE

I hereby give my perrrussion to the respective high school and/or college I attend or plan to attend to release a copy of my transcript of grades, class rank, college board scores, and financial aid commitments offered to me as an enrolling students. I also agree to permit to share the information on my P.G. & Ruby Rush Hollandsworth Perpetual Scholarship Application, together with the supporting financial data, with any other student aid funding source to which I have applied. I further certify that the information contained in my application is complete and accurate to the best of my knowledge.

Signa ture of Person Accessing File Appli cant's Signature

Date of File Access *Witness to Applicant's Signature

*The witness to this application should be a person who can vouch for the validity of information contained on the student's application. You are, therefore, urged to find a witness who knows you well enough to support the statements you have made.

6 1-2007