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2019 Alexander G. Gray, Jr., Scholarship Award - Application Form

ALEXANDER G. GRAY, JR. SCHOLARSHIP AWARD

APPLICATION FORM

2019

 

 

            GENERAL INSTRUCTIONS

 

            There are three parts to this application form.  Part I requires certain biographical information.  Part II requires short answers to questions aimed at learning more about the applicant.  Part III requires certain documentary attachments.  All completed applications must be submitted in PDF format as an email attachment by 5:00 PM on Friday, March 15, 2019, to Peter Hahn (peter@peterhahnlaw.com).   Incomplete applications will not be considered.

 

 

I.          BIOGRAPHICAL INFORMATION

 

 

Name: ____________________________________________________________

 

Preferred pronoun:  _________________________________________________

 

Address:  __________________________________________________________

 

               ___________________________________________________________

 

Telephone:      Day:  ________________________________________________

 

Evening:  _____________________________________________

E-mail:  ___________________________________________________________

 

Law School:  _______________________________________________________

 

Expected Year of Law School Graduation: ________________________________

(You must be enrolled in law school for the 2018-2019 school year to be eligible.)

 

Are you a member of the Mass. LGBTQ Bar?  ______________________________

 

If so, since when have you been a member?  _______________________________

 

 

II.        SHORT ESSAY QUESTIONS (limit answers to one to two paragraphs in length; please type or write answers below)

 

1.      List and briefly describe your activities in or commitments to the LGBTQ community.  To provide the committee with a better understanding of all aspects of your activities, please also include activities and commitments that are not included on your current resume.

 

 

 

 

 

 

 

 

 

 

 

 

 

2.      As a future lawyer, how do you think you can best contribute to the LGBTQ community?

 

 

 

 

 

 

 

 

 

 

 

 

 

3.      Please briefly describe how you would utilize the funds, if awarded to you.

 

 

 

 

III.       OTHER REQUIRED DOCUMENTS (include with this application form)

 

      Current résumé

      Transcript from your law school (unofficial is acceptable)

      Recommendation from a professor, employer, or work colleague (not related to you)

Certification

I have read and understand all of the terms and conditions of the Alexander G. Gray, Jr. Scholarship Award.  I understand and acknowledge that I must be enrolled at least half time and in good standing at a law school in the Commonwealth of Massachusetts during the 2018-2019 academic year as a second year (2L) or third year (3L) student to be eligible for and receive the award.  I understand and acknowledge that I must be a student member in good standing of the Mass. LGBTQ Bar to be eligible to receive the award.  I understand that I am eligible only if I have paid at least $3500 for expenses directly related to my enrollment in law school. 

I understand and acknowledge that I must comply with all the stated terms and conditions of the Scholarship and that my failure to do so may result in forfeiture of the entire Scholarship award.  I understand that the officers and voting directors of the Mass. LGBTQ Bar and members of the Mass. LGBTQ Bar Scholarship Committee, and their immediate family members, are ineligible for the Scholarship award, and I hereby certify that I am not ineligible for the Scholarship on the foregoing basis.

I understand that all materials submitted to the Mass. LGBTQ Bar will become the property of the Mass. LGBTQ Bar, which will handle submissions with discretion, but which reserves the right to issue public announcements regarding the winner of the Scholarship award and to publish the winner’s essay and/or other information about the winner.  If selected for the award, and if I desire to preserve privacy with respect to information I shared that may be personal in nature, I will promptly so notify the chair of the Scholarship committee in writing and the Mass. LGBTQ Bar will endeavor to respect that request.

I certify that all of the information submitted with and all of the statements made in this application or in any document attached hereto are true and accurate to the best of my knowledge as of the date signed below.  I certify that the essay attached hereto was written solely by me and is my original work.

If awarded the Alexander G. Gray, Jr. Scholarship Award, I agree to attend the 2019 Mass. LGBTQ Bar Annual Dinner.

 

 

_______________________________________________________            _______________________________

                        (Signature or e-Signature*)                                                                (Date)

 

 

* For an e-Signature, type “/s/” and then your name in the space above.

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