Scholarship Application

 

 

Name of Scholarship:      

Name:      

Address:      

City:      

Zipcode:      

Phone:      

Father:      

Occupation:      

Employer:      

Mother:      

Occupation:      

Employer:      

Number of dependents:      

Ages:      

 

 

Income range of family

 

 Under $15,000

 $30,000 - $35,000

 $15,000 - $20,000

 $35,000 - $50,000

 $20,000 - $25,000

 $50,000 - $70,000

 $25,000 - $30,000

 Over $70,000

 

Explain why you need this scholarship:      

University you plan to attend:       Major:      

Do you plan to work while you attend college? Yes No

List academic awards and honors:      

List extra-curricular activities including hobbies & special talents:      

 

Job Experience

Company

Date of Employment

Duties

     

     

     

     

     

     

 

 

► Enclose a copy of your transcript

► Answer the following statement:

    

What do you plan to be doing in ten years?