FRANKLIN WOMAN’S CLUB

APPLICATION FOR SCHOLARSHIP

 

Purpose: The purpose of this scholarship is to assist you; in paying for books, academic expenses such as laboratory fees, and similar educational expenses such as for a personal computer. If you receive this scholarship, you will need to provide copies of your expenses to the club treasurer to receive reimbursement.

 

Applicant:

 

     

(Last Name, First Name, Middle Initial)

 

     

(Street Address)

 

     

(City)

 

     

(Zip Code)

 

     

(Phone Number)

 

     

(Date of Birth – MM/DD/YYYY)

 

     

(Name of parents or guardian with whom you reside)

 

Is father employed?                  Is mother employed?

 

How long have you been a resident of Franklin Township?      

 

What high school are you attending?

     

(Please list name of school, city and years attended)

 

List the college you plan to attend and the estimated expenses (tuition, room and board fees) for one year

     

 

What degree will you pursue and what do you plan to study?

     

 

Activities: Please describe the school and community activities you participate in, any honors you received and any special interests or hobbies you have.

     

 

Work experience: Do you work for pay, where, and how long have you been employed there?

     

 

 

Please tell us about any community service you have done.

     

 

Provide the name and phone number of an educational reference

     

 

Is there any other information that we should consider?

     

 

Please attach a copy of your high school transcript. (If you cannot attach a copy of your transcript on-line, please indicate that you will send it via regular mail.)

     

 

The above information is true and complete. I understand that if I am selected as the recipient of this award, my name may be included in a press release by the Franklin Woman’s Club.

 

Signature of Applicant (Electronic signature or type your name)

     

 

Date (MM/DD/YYYY)

     

 

Signature of Parent or Guardian

     

 

Relationship

     

 

Date (MM/DD/YYYY)