Johnnie And Linda Melia Memorial Scholarship Application
Select prompt:
– “Ethics as a cornerstone of a business” – Essay (500-800 words)
– “How to select a good moving company” – Essay (500-800 words)
– “Funny video on the moving process” – Video (Must be original and be 2-5 minutes in length)
Personal Information
Please attach a yearbook-style picture of yourself to this application for publicity purposes.
Name_______________________________________________________________________________________
High School (if in grade 12)____________________________________________________________________
City and County______________________________________________________________________________
Home Address_______________________________________________________________________________
City______________________________________ State________________________ Zip Code_____________
Home Phone Number___________________________ Mobile Phone Number___________________________
Email Address__________________________________________________________ Gender: Male Female
Weighted GPA_______________ Class Rank:__________ of ____________ total students
SAT or ACT Scores: V______________ M_______________ W______________ Combined_________________
Intended Major_______________________________________________________________________________
College/University attending or planning to attend___________________________________________________
If undecided, list any colleges or universities applied to or accepted___________________________________________
List of all scholarships applied for and the status______________________________________________________________________________
__________________________________________________________________________________
___________________________________________________________________________________
Mother’s Name or Legal Guardian__________________________________________________________________
Home Address__________________________________________________________________________________
City, State, Zip Code_____________________________________________________________________________
Home Phone____________________________________ Mobile Phone___________________________________
Email Address__________________________________________________________________________________
Employer_______________________________________ Occupation_____________________________________
Father’s Name or Legal Guardian___________________________________________________________________
Home Address__________________________________________________________________________________
City, State, Zip Code_____________________________________________________________________________
Home Phone____________________________________ Mobile Phone___________________________________
Email Address__________________________________________________________________________________
Employer_______________________________________ Occupation_____________________________________
Please list any circumstances that may affect your ability to pay for college: _____________________________________________________________________________________________
_____________________________________________________________________________________________
Referral Information
How did you hear about the Johnnie And Linda Melia Memorial Scholarship Program? ________________________________________
_____________________________________________________________________________________________
Extracurricular Activities
Sports, clubs, volunteer work, fine arts, scouting, jobs, church involvement, hobbies, internships and special interests.
| Activity | Years Participated | Hours Per Week |
By signing below, I certify that the information provided in this application is accurate and complete to the best of my knowledge. I understand that falsification of any information will result in termination of any scholarship granted. I also understand that incomplete or late applications will not be considered for this scholarship. In the event that I receive the Johnnie And Linda Melia Memorial Scholarship, I permit the company to use my presentation, name and likeness in publicity materials relating to the scholarship.
_________________________________________________________
Signature of Applicant
_________________________________________________________
Signature of Parent or Guardian (if applicant is a minor)
_________________________________________________________
Date of Application
Submit your application and supporting documents by U.S. mail to:
JT Melia Moving & Storage – Scholarship
ATTN: Brandon Melia
2527 Fairway Park Dr.
Houston, TX, 77092
Release Form for Participants
To be completed by all visible AND/OR audible participants in the video:
By signing below, I authorize (applicant name)____________________________to publicly share my likeness, voice and on- or off-camera performance with JT Melia for the purpose of his or her scholarship entry. I further authorize JT Melia to publicize the entry at will, including but not limited to social media outlets, the company’s website, and promotional materials. I agree to hold JT Melia and its employees harmless from any liability related to the scholarship contest or the award process.
| Name | Signature | Guardian Name(If Minor Child) | Date |
Local and Long Distance
Office Relocations
International Movers
Houston Long Term Storage