Edward Mitchell Fund
Online Application

Before beginning, please make sure you have read all instructions
carefully. (Failure to follow these instructions may result in your application being disqualified.)

Important: The information on this application cannot be saved, therefore, please allow some time to complete the application in full. Once this application has been submitted, it cannot be changed.

1. These grants are available to students who have completed one or more years of education beyond the high school level, and are residents of Merrick County.
2. Application is available online only.
3. Applications will be considered semi-annually at the June and November director's meetings, and must be submitted before June 1st and or November 1st.
4. The applicant must show good scholastic progress, and demonstrate financial need for continuing education. ONCE YOU HAVE SUBMITTED THIS APPLICATION, PLEASE CLICK HERE TO DOWNLOAD THE FINANCIAL FORM TO COMPLETE AND MAIL INTO THE MERRICK FOUNDATION OFFICE BEFORE THE DEADLINE.
5. Payments will be made directly to the school.
6. The amount of grant will not exceed $300 and no more than six will be awarded in any one year.
7. If a student is a recipient for June, he/she will not be considered as a November applicant.
8. Statement of purpose portion of this application must be completed in full to be considered for the grant.

EDWARD MITCHELL FUND APPLICATION


Section A:

 Name:
Social Security No.:
Address:
City, State, Zip:
Marital Status:
Telephone:
Birthdate (mm-dd-yy):
Parent's or Spouse's Name:
School You Plan to Attend:
Year You Will Be In School 
Major:
Current GPA:

Section B:

Will you live with your parents while in school?  Yes No
Total number of residents in your parent's household, including yourself:
Can your parents claim you on their income tax return?   Yes No


Section C:  (Fill in this section only if married, divorced, or widowed)

Total number in your household, including yourself:
Ages of dependent children:
If married, is your spouse employed?  Yes No
By whom?


Section D:

Itemize your expected expenses of this year's education,
Tuition $:   Books $:   Room & Board $:


Section E:

Download the financial form and fully complete. Then mail to the Merrick Foundation office at: Merrick Foundation, P.O. Box 206, Central City, NE 68826. 

Section F: 

REQUIRED. Please write a short essay explaining why you are applying for this grant.
(200 word maximum).

 

* This application, email disclosure form, and financial form must be on file in the Merrick Foundation office by June 1st or November 1st to be considered. 

All Applicants:
Enter your email address so we may contact you with any questions.
Email:

Email Disclosure: All information submitted in this application is complete and accurate to the best of my knowledge. I understand that by signing this disclosure, I am giving my permission for the Merrick Foundation to use the information at its discretion for publicity purposes.

ELECTRONIC SIGNATURE: (Please type the last 5 digits of your social security no. to verify you have read and understand the above Email Disclosure:



For your records, it is recommend you print out the above application before 
hitting "Submit". 


Contact Information:

Merrick Foundation, Inc.
P.O. Box 206, Central City, NE 68826
Phone: 308.946.3707 Fax: 308.946.3049
General Information: merrickf@hamilton.net