First Name *

Middle Name/Initial

Last Name *

Email *

Phone *

Address 1 *

Address 2

City *

State/Province *
- Select State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Afr/Can/EU/ME Armed Forces Americas Armed Forces Pacific Baker Island California Colorado Connecticut Delaware Federated State of Micronesia Florida Georgia Guam Hawaii Howland Island Idaho Illinois Indiana Iowa Johnston Atoll Kansas Kentucky Kingman Reef Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Midway Islands Minnesota Mississippi Missouri Montana Navassa Island Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Palmyra Atoll Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territory of Pacific Utah Vermont Virgin Islands Virginia Wake Island Washington Washington D.C. West Virginia Wisconsin Wyoming

Zip/Postal *

Mary Jane Dockeray Scholarships are awarded to graduating from high school seniors from public or private schools in the Kent, Muskegon, and Ottawa Intermediate School Districts with an interest in pursuing a career in science. Please fill in your school information below: 

Present High School *

Date you expect to earn your high school diploma *

List previous honors or awards *

Your intended field of study, if known. If unknown, please enter "undecided" *

Your career goal, if known. If unknown, please enter "undecided" *

PLEASE READ: If you are looking to attend Grand Valley State University, any transcripts sent to the University, cannot be viewed by our department. Please make sure to upload your transcript. Thank you!

Please upload your transcript below *
Please upload a file with the extension .doc, .pdf, .docx, .jpeg, .jpg, or .png with a maximum size of 2 MB (2048 KB)

Personal Essay Information: Your personal essay should include personal information about yourself, educational, and career goals. However, do not merely list activities, honors, and awards. Instead, help the selection committee understand your uniqueness in an essay format. To accomplish this, it would be a good idea to write in the first person (use "I"). Try to make yourself come to life as an individual, a student, and a future member of your chosen science profession. Remember, the committee has to read many applications. Help the committee understand why they should choose you for the scholarship.

Upload (PDF format preferred) *
Please upload a file with the extension .doc, .pdf, or .docx with a maximum size of 2 MB (2048 KB)

As the applicant, you must have two recommendations as required to complete the application.

• One recommender must be a current teacher/administrator from the applicant's school
• One recommender cannot be connected with your high school

NOTE: It is your responsibility to send this link (Mary Jane Dockeray Scholarship) to your recommenders to fill out their own recommendation form. 

Name of recommender related to your school *

Job title *

Name of recommender NOT related to your school *

Job title *

PLEASE READ: I will call or email you if your application is incomplete before the deadline. This will give you enough time to update any missing information. Applications that remain incomplete after this deadline will not move forward in the process