Big Sandy Area Community Action Program

Big Sandy Area

Community Action Program

2022

Eula Hall Community Advocate

Scholarship Application

2022 Community Services Block Grant

Eula Hall Community Advocate Scholarship

$2,000

The Promise of Community Action:

Community Action changes people’s lives,

embodies the spirit of hope, improves communities,

and makes America a better place to live.

We care about the entire community,

and we are dedicated to helping people

help themselves and each other.

During her life, Eula Hall was the personification of the Community Action Promise. Thousands of lives in our

region have been changed for the better because of her unassailable spirit and indomitable will. For more than

35 years, she served on the Big Sandy Area Community Action Program Board of Directors and it is with

gratitude that we name this scholarship in her honor.

Hall lived her life as an advocate for the workers, children, and families of the region. She served with the

Volunteers in Service to America, the Appalachian Volunteers, the East Kentucky Worker’s Rights

Organization, and as president of the Kentucky Black Lung Association. She created the Mud Creek Water

District, and in 1973, established the Mud Creek Clinic to serve uninsured and underinsured people. The Mud

Creek Clinic, now known at the Eula Hall Health Center, offers general clinic care, pharmacy, dental care,

optometry, mental health services, patient transportation, public benefits guidance, and a food pantry.

Hall said, “I love to be a part of my community. I love to be available to help people on anything I can, anything

I know that’s going to benefit them. And any program we can bring to the community, I love to do it. I like to

be the person that does it. […] You’d be surprised what you can make work.”

She was a pioneer for health in eastern Kentucky and a staunch advocate for the poor. Through the years she

picketed at coal mines for better treatment for the workers, pushed for laws to aid suffers of black lung, raised

thousands of dollars to bring medical services to her community, ensured that the people of Mud Creek have

clean water to drink, and given money from her own pocket for food or medicine for people in need. She said,

“A lot of times a good word is what somebody needs, a good word or a good deed. They need somebody. They

need somebody to care.”

The sacrifices she made throughout her life and the actions she made are an example to all of us who want to

serve our communities and it was a privilege to serve alongside her.

Ms. Hall passed away in 2021, but her spirit lives on.

To the applicants of the scholarship, Hall said, “Learn to care for people and remember where you come from.

Don’t never forget your upbringing, who you are, and where you come from. It don’t matter how far you go in

life, when you look back, remember the people who are not as fortunate as you are.”

Through this scholarship, we seek to honor the life and work of Eula Hall on behalf of the grateful people of

eastern Kentucky and encourage the next generation of advocates to rise to the same heights.

2022 Eula Hall Community Advocate

Scholarship Application Information

Thank you for applying for the Eula Hall Community Advocate Scholarship. Big Sandy Area Community

Action Program (BSACAP) understands that you may have questions regarding the application process. The

information provided below should help you. If you have further questions, please contact the Community

Services office in your county.

What type of scholarship is offered?

Big Sandy Area Community Action Program offers an annual $2,000 scholarship to CSBG-eligible

applicants within the Big Sandy area. This one-time cash scholarship may be used for any expenses that

the applicant incurs while pursuing a post-secondary education.

Am I eligible?

In order to qualify for the scholarship, applicants must:

 Major in Social Work, Human Services, Public Services, or related fields

 Have a history of participation in volunteer work

 Be in at least their 3

year of study

 Fulfill the requirements of the regular CSBG Scholarship application.

 Be enrolled as a full-time student in the Fall 2022 semester of a post-secondary institution

 Have a GPA of 3.0 or above

 Live in a household that falls below the 200% federal poverty level

 Live within the BSACAP service area (Floyd, Johnson, Magoffin, Martin, or Pike Counties)

Please note:

 Master’s and Graduate Degree candidates are ineligible to apply.

 BSACAP staff or family members of BSACAP staff are ineligible to apply. This includes spouses,

children, parents, siblings, grandparents, nieces and nephews.

 Applicants may apply for both the Eula Hall Community Advocate Scholarship and the

Community Services Block Grant (CSBG) Scholarship, but they may only win one.

 Individuals may only win the Eula Hall Community Advocate Scholarship once. Scholarship does

not renew.

What information or documentation do I need to apply?

Applicants will need to provide the following information to be eligible for the scholarship:

 Applicants must complete and sign the scholarship application, including the case management

authorization form.

 Applicants must have a Service Assessment completed by a CSBG staff member. The Service

Assessment must include the social security number, date of birth, and verification of monthly

income for every household member. Applicants must provide proof of and meet CSBG income

guidelines. The original Service Assessment will be given to the applicant for inclusion in their

application packet, with a copy retained by CSBG staff. ALL pages of services assessment

must be signed by the applicant.

 Applicants must provide proof of their cumulative grade point average (GPA). A minimum GPA of

3.0 is required to be eligible.

 Two letters of reference are needed for the application. One letter of reference should be from a

representative of an educational institution (this may be from a guidance counselor/advisor, teacher,

or professor.) The other letter of reference should be from someone you know personally. This

could be a church/clergy member, co-worker, caseworker, community or civic leader, etc., but

cannot be from a BSACAP staff member or relative of a BSACAP staff member.

 Applicants must provide proof that they are enrolled as a full-time student (at least 12 credit hours)

in a post-secondary educational institution for the Fall 2022 semester/term.

 Applicants must be in at least their 3rd year of study. Extra points will be awarded to individuals in

the final year of their undergraduate degree.

 Applicants must provide documentation of a Major in Social Work, Human Services, Public

Services, or related fields. This may be a copy of the major declaration form or a signed letter from

the applicant’s academic advisor if the major is not explicitly stated on the applicant’s academic

transcript.

 Applicants must provide documentation of their volunteer work. This may be a signed letter from the

volunteer supervisor on organizational letterhead stating hours served and capacity in which service

was provided. Extra points will be awarded to individuals who served at a nonprofit organization.

 Applicants must write an essay on why they feel that they should receive this award. Please include

any personal success, recognition, or special need that motivates you to pursue a post-secondary

education. The essay should be two (2) typed pages, double-spaced, using one-inch margins and a

12-point font. Essays that do not meet these specifications will not be counted and render the

applicant disqualified.

 Applicants must provide proof that they live within the BSACAP service area (Floyd, Johnson,

Magoffin, Martin, or Pike counties). This may be a utility bill with service address or a piece of first

class mail post marked within 30 days of application.

 Applicants who are the first in their immediate family to attend college may provide a notarized

statement from a family member or school official to document said statement.

 Applicants must agree to participate in BSACAP case management for one year.

How are the scholarships awarded?

Scholarships will be awarded based on a ratings point system that includes the application, essay, GPA, and

other criteria. In the event of a tie, postmark date/earliest timestamp will take precedence. One $2,000

scholarship will be awarded to one recipient. The recipient will be notified when to pick up their scholarship

check, and must be present to receive it. Checks will not be mailed to recipients.

When are the scholarships awarded?

Scholarship packets cannot be returned by hand to any BSACAP office. They must be mailed to

BSACAP, Attention: CSBG Scholarship Program, 230 Court Street, Suite 323, Paintsville, Kentucky

41240, no later than Friday, June 24, 2022. Packets received after June 24 must have a valid US

postmark for that date. Scholarships will be awarded no later than July 29, 2022.

Note: Incomplete packets WILL NOT be reviewed.

2022 Eula Hall Community Advocate

Scholarship Application

Applicant Name _______________________________ Social Sec. # ___________________

Home Phone # _______________________________Alternate Phone # __________________

Home Address __________________________________ State ______ Zip Code _________

Annual Household Income _____________________________________________________

College or University Where Applicant is Enrolled __________________________________

Cumulative GPA __________________

Are you the first member of your immediate family to attend college? Yes No

Do you wish to be considered for the 2022 CSBG Scholarship as well? Yes No

Please attach separate sheets with information for each of the following:

1. Service Assessment (must be completed by BSACAP staff according to CSBG guidelines and all pages must be

signed by applicant)

2. Verification of residency (A utility bill OR piece of first class mail received within 30 days of application)

3. Verification of income and social security number for every household member (Proof of CSBG income

eligibility is required)

4. Copy of academic transcript.

5. Verification of cumulative GPA, major, and at least 3

year status if information is not provided on transcript

6. Verification of volunteer work

7. Two letters of reference

8. Verification of Fall 2022 semester/term enrollment in a post-secondary institution

9. Essay completed to required specifications

10. Notarized statement from family member or school official documenting applicant as first time family member

attending post-secondary educational institution, IF APPLICABLE

11. Signed Case Management Authorization form

12. Signed Release of Information form

I attest that the information provided in this application is true to the best of my knowledge, and I agree to comply with

the terms of this award. I further understand that if I fail to submit this application and all required items by

4:30pm on Friday, June 24, 2022, my application will be disqualified. Applications received after June 24 must

have a valid US postmark for that date.

________________________________ _____________________________ _________________

Applicant’s Signature Parent/Guardian Signature (if under 18) Date

Received by: ________________________________________ Date/Time: _________________________________

Applicants who have earned a 4-year degree or are pursuing education levels of Masters Degree and above are not eligible. BSACAP staff or Family members

of BSACAP staff are ineligible to apply. This includes spouses, children, parents, siblings, grandparents, nieces and nephews.

Scholarship funding made possible by Community Services Block Grant with funds made available by the Cabinet for Health and Family

Services and the U.S. Department of Health and Human Services.

Big Sandy Area Community Action Program

2022 Eula Hall Community Advocate Scholarship

Case Management Authorization Form

In order to receive the 2022 Eula Hall Community Advocate Scholarship, applicants must

first agree to be case managed for up to one year by BSACAP staff. This will include monthly

contact (at minimum) for education follow ups. Case management may also include requests for

copies of semester grades or documentation of post-secondary education completion (if

applicable). If the applicant fails to return Case Manager calls, emails, or requests after

receiving the scholarship, they will become ineligible for the CSBG scholarship in future years.

I, __________________________, hereby authorize BSACAP staff to contact me

monthly for case management services and agree to provide any information that they may

require. I understand that failure to communicate with my CSBG Case Manager will result in

ineligibility for future CSBG scholarship opportunities.

Signed this _______ day of ________________, 2022.

_____________________________ _______________________________

Applicant (print) Address

_____________________________ _______________________________

Applicant (signature) City, State, Zip

_____________________________ _______________________________

Email Witness (print)

_____________________________ _______________________________

Phone Witness (signature)

Big Sandy Area Community Action Program

Release of Information

_____________________________________________

Name – Please Print

_____________________________________________

Address

_____________________________________________

City County State Zip Code

_____________________________________________

Home Phone Alternate Phone

I authorize Big Sandy Area Community Action Program (BSACAP) to use my

photograph, statements, and related information for publicity purposes.

_____________________________________________

Signature Date

_____________________________________________

Witness Date

230 Court Street, Paintsville, Kentucky 41240

606/ 789-3641

Big Sandy Area Community Action Program

Notice of Client Appeals Rights

Under various titles of federal law, Kentucky Revised Statutes and pursuant to terms of contracts and

agreements with and through the Kentucky Cabinet for Health and Family Services, this agency is required to

provide a hearing to any applicant or recipient of servicers who is aggrieved by any agency action resulting in

denial, suspension, discrimination, exclusion, or termination of services administered under federal or state

statute or funding pertaining to its administered programs.

This agency, as a grantor, and/or contractor in the public interest, hereby affirms its compliance with this policy

and directs its staff to act accordingly.

Please consider your receipt of this statement as your personal and formal notice of your right to a fair hearing

should you be aggrieved by any covered action by this agency or its staff.

If you are dissatisfied with the action by the agency, you may request a fair hearing of your complaint. Your

request must be filed in writing within thirty (30) days* of the action you wish to appeal. You may appear by

letter or by completing an appeal form which may be obtained from the agency’s local county coordinator.

Your complaint must contain:

 Your full name, complete address, and telephone number;

 A detailed statement of the nature of your complaint, including the date and place of the agency

action and the agency program or service involved;

 Name(s) and addresses (at least their office or service location) of staff you believe treated you

inappropriately;

 Your signature and/or that of your authorized representative, if any; and

 A clear indication whether your complaint pertains to service or involves alleged discrimination.

Please forward your complaint to:

Executive Director Equal Opportunity Officer

BSACAP BSACAP

230 Court Street OR 230 Court Street

Paintsville, KY 41240 Paintsville, KY 41240

A full and complete statement of the agency’s fair hearing policy is available upon request, with reasonable

processing considerations, through the agency’s office of the Executive Director.

*USPS postmark or agency date-of-receipt stamp will serve to verify timeliness.

Big Sandy Area Community Action Program

2022 Eula Hall Community Advocate Scholarship

Application Check Sheet

Name ________________________________ County _____________________

__________ Completed Application

__________Signed Case Management Authorization Form

__________Signed Release of Information

__________ Service Assessment (completed by CSBG staff with proof of income, proof

of residency, copies of social security cards and all pages signed by applicant)

__________ College Transcript

__________ Verified Current GPA

__________ Verified Major

__________ Proof of Full Time (12 hours) College Enrollment for Fall 2022 Semester

__________ Verification of Volunteer Work

__________ Letters of Recommendation (2)

__________ Applicant Essay Completed to Required Specifications

__________ Notarized, written statement declaring that applicant is the first person in the

immediate family to attend a school of post-secondary education (if

applicable)

Mail Signed and Completed Packet to:

Big Sandy Area Community Action Program

Attention: CSBG Scholarship

230 Court Street, Suite 323

Paintsville, Kentucky 41240

Applicants who have earned a 4-year degree or who are pursuing education levels of Masters Degree and above are not eligible. Staff or

family of BSACAP staff, including spouses, children, parents, siblings, grandparents, nieces and nephews are ineligible.

Big Sandy Area Community Action Program

CSBG Community Service Offices

Floyd County Service Office

60 Court Street

Allen, KY 41601

606/ 874-3595

606/ 874-1281 (fax)

Johnson County Service Office

Johnson County Courthouse, Third Floor

230 Court Street

Paintsville, KY 41240

606/ 789-6515

606/ 789-4344 (fax)

Magoffin County Service Office

131 Church Street

Salyersville, KY 41465

606/ 349-2217

606/ 349-6148 (fax)

Martin County Service Office

Roy F. Collier Community Center

387 East Main Street

Inez, KY 41224

606/ 298-3217

606/ 298-3257 (fax)

Pike County Service Office

478 Town Mountain Road

Pikeville, KY 41501

606/ 432-2775

606/ 432-7145 (fax)