Hawthorne Fortitude Lodge Leon Muller Charity Fund, Inc.
Scholarship Application Form Directions
Eligibility for this scholarship is based primarily on financial need. You will be asked to
prove your eligibility for this scholarship. The proof will be in the form of copies of the
parent’s tax returns and the student’s tax returns, if applicable. Please white out any
social security numbers for privacy. Any other documentary written evidence can also be
We are desirous of providing you with a scholarship for four consecutive years while you
are attending school. You will be required on a semester basis to prove that you are a
student in good standing and that financial need still exists. We will send the annual
allotment of scholarship money directly to the institution you are attending as soon as you
have provided the information we have requested.
Failure to accurately complete the attached application and provide us with documentary
proof will eliminate you from this process.
With your scholarship packet please include: Parents’ W2 Tax Form or Forms, Official
High School Academic Transcript, and Two Letters of Recommendation from
persons not related to the applicant.
APPLICATION DEADLINE: MAY 10th 2011
Hawthorne Fortitude Lodge #200 F. &A. M.
Attn: Leon Muller Charity Fund, Inc.
24 N. Franklin Turnpike
Ramsey, NJ 07446