- Official Application Form -
1. Please print or type
2. Complete all blanks, were applicable.
3. March 31, 2010 is the postmark deadline for this application.
4. Please submit this original application.
5. High school seniors - in order to be considered, this application must be
accompanied by letters of recommendation as described in #3 of the guidelines.
6. You are invited to submit any additional optional information desired.
Name ____________________________________________________________________________
Address __________________________________________________________________________
City/State/Zip ______________________________________________________________________
Telephone #'s: Home: ( ) _________________________ Cell ( ) ________________________
Email address __________________________________ Birthdate ___________________________
Qualifying parent / guardian __________________________________________________________
Union or Auxiliary member since _______________________________________________________
University / college you plan to attend ___________________________________________________
Career choice _____________________________________________________________________
Record of participation in high school organizations, leadership positions,and activities
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Any other activities, awards, community service, work experience:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Statement by applicant: On a separate sheet of paper, write about yourself, keeping your comments
one page in length please. Describe your goals and philosophy of life. Your comments can be serious,
whimsical, etc. Use your imagination and let your personality shine. This is a crucial part of your
application and provides the board a better opportunity to get acquainted with the real you.
To go back to the Scholarship Rules and Regulations page please click HERE.
