BARBARA ANN BOONE MEMORIAL SCHOLARSHIP
with LIVING IN FUTURE TENSE (LIFT) Youth Healthy Decisions Coalition – Together for Resilient Youth
We Believe in: Honesty, Caring Integrity, Equality, Social Justice
We believe that youth are our future so we must give them the opportunity to soar!

REQUIREMENTS FOR CONSIDERATION
Current 3rd - 5th ($75) Current 6th - 8th ($150) Current 9th - 10th grader ($250) Current 11th grader ($500) Current 12th grader ($1,000 to College/University $250 student). Awardees MAY be selected to attend an International prevention conference in July held in Dallas, Texas.

The $1,000 SCHOLARSHIP to the College that they will attend.

All students agree to participate in LIFT during the school year.

Contact Dr. Wanda Boone 919-491-7811 or wanda.durhamtry@gmail.com for more information

Instructions
Please complete this form BEFORE March 15, 2019. Selections will be made by April 1, 2019. Awards will be presented on April 12, 2019 at the TRY Prevention Annual Conference 2019! Late and/or incomplete applications will not be considered.
Your name: *
Your address: *
Your phone number: *
Your email address: *
Your age: *
Your birthdate *
Your grade: *
Required
Your school: *
Upload a picture of yourself *
Required
Join LIFT and Social Media
List your social media platforms (3RD - 4TH NOT APPLICABLE) *
What school clubs, religious organizations, community groups, etc. do you belong to? DESCRIBE WHAT YOU DO WITHIN THE GROUPS (Please list)
What are your hobbies? WHY DO YOU ENJOY THEM? *
What are your previous and/or current volunteer experiences? DESCRIBE
1. Stress must be managed in order to live a healthy life. How do you keep stress away? Number of Characters: 3rd - 5th 25+; 6 - 9th 100+; 10th - 12th 200+ *
2. Describe what Honesty this means to you? Number of Characters: 3rd - 5th 25+; 6 - 9th 100+; 10th - 12th 200+
3. Describe what Caring means to you? Number of Characters: 3rd - 5th 25+; 6 - 9th 100+; 10th - 12th 200+
4. Describe what Integrity means to you? Number of Characters: 3rd - 5th 25+; 6 - 9th 100+; 10th - 12th 200+
5. Describe what Equity means to you? Number of Characters: 3rd - 5th 25+; 6 - 9th 100+; 10th - 12th 200+
6. Describe what Social Justice means to you? Number of Characters: 3rd - 5th 25+; 6 - 9th 100+; 10th - 12th 200+
7. Barbara Ann Boone displayed the qualities that you wrote about above! She may not have been known by many. To her family she was the strength and pillar. To her nieces and nephews she was the silent supporter. She completed tasks on time. She was hardworking, focused, cared about health, cared about her family, helped her parents and helped others. She loved to travel. She enjoyed learning about different cultures. You may not meet all of her attributes yet, but pick one or more and write an essay about what brings you a spark and a LIFT! #WORDS: 100 (3rd - 5th) 250 (6th-7th) 500 (8th -10th) 700 (11th) 1,000 (12th) Pictures, PLUS poems/words of your choice: *
Required
Parent's Name *
Parent's phone number *
Parent's email address *
Parent: My child should receive this scholarship because... *
Required
Parent's Affirmation: I agree with my child applying for this scholarship. *
Required
NAME OF OTHER ADULT (RECOMMENDATION) Cannot be a relative *
Adult's address *
Adult's phone number *
Adult's email address *
Describe your relationship to the Adult *
Upload a video about why you want to be a voice for youth through TRY/LIFT. Begin the video with "My name is, I am a voice for youth. Let's LIVE IN FUTURE TENSE and TRY together!" The video must include the importance of being a role model; substance use free, healthy, and safe. *
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