NATIONAL HONOR SOCIETY
SCHOLARSHIP
This scholarship is to be awarded to a Louisburg High School Senior National Honor
Society member. The scholarship will be awarded at the May graduation ceremony.
The member must be pursuing an education at a college or vocational school of
his/her choice. The scholarship will be chosen on the basis of: Financial need,
GPA, Curriculum, School and Community Activities, Work Activities, and a personal
interview.
Amount
The amount of this scholarship shall be $250.00.
Payment
Upon enrollment at the institution of the recipient's choice, he/she must request the
institution to provide the National Honor Society advisor with proof of enrollment. A
check will then be sent to the institution.
Application For The Award
Students are required to return the application to the counselor's office by April 1.
Personal Interview
Besides filling out the application, students may be interview by selected members of
the Louisburg High School faculty.
Requirements
The students must be a current member of the Louisburg Chapter of the National
Honor Society.
National Honor Society Scholarship
Application Form
Name: ______________________________________ Date: _____________
Address: ______________________ City: _______________ State: _______
Date of Birth: __________________________ Age: ________
Father's Name:____________________ Occupation: ________________
Mother's Name: ___________________ Occupation: ________________
List other Children living at home and ages
Name: _____________________ Age: _____________
Name: _____________________ Age: _____________
Name: _____________________ Age: _____________
Name: _____________________ Age: _____________
Name: _____________________ Age: _____________
Parent's adjusted gross income from last year's tax return:
_______ under 15,000 _______ 26,000 to 30,000 _______ 41,000 to 45,000
_______ 15,000 to 20,000 _______ 31,000 to 35,000 _______ 46,000 to 50,000
_______ 21,000 to 25,000 _______ 36,000 to 40,000 _______ Over 50,000
Total number of dependents on your parent's income: ___________________
Total number of family members attending college: _____________________
Other financial considerations which need to be noted: __________________
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GPA _______________ Class Rank _______________
Please list your classes for your Junior and Senior Year and grades received in each
Junior Year Class Taken 1st Sem Grade 2nd Sem Grade
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Senior Year Class Taken 1st Sem Grade 2nd Sem Grade
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Please list all extra-curricular activities at school you have participated in:
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List all honors and awards you have received during your high school career:
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Please list your community activities or other non-school related activities you have
been involved in:
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Are you now employed? _________
If yes, what type of work do you do? ________________________________
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Do you have any other work activities needing to be mentioned? __________
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What career do you plan on pursuing? ______________________________
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Where do you plan to go to school? ________________________________
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Why do you want to go to college? _________________________________
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