CARROLL UNIFIED SCHOLARSHIP FORM
Please check the scholarship(s) for which you are applying:
Ashton Memorial Scholarships *Dellroy Ruritan (Grads also)
Bell-Herron Foundation (Grads also) Dellroy Order of Odd Fellows
*Carrollton Business Women *Moyne Smith Memorial (Grads also)
*Carrollton Civic Club *Perry Twp. School Memorial (Grads too)
*Carroll County Historical Society Richard and Joyce Hannon (Grads also)
*Carroll County Farm Bureau (Grads also) *Russell and Henry Cole
Carrollton Rotary *Scholarship 19 (Grads also)
= Additional form must accompany this application to qualify. It is available in the back
of this booklet. First scholarship deadline from list, is 3/1/10, other deadlines are listed
elsewhere in application.
Parents/Step (who live in the home with you), place of employment and job title.
Household Income Range for 2008 (please check)
Less than $15,000 $15,001 to $30,000 $30,001 to $45,000
$45,001 to $60,000 $60,001 to $75,000 over $75,000
Siblings (# in the home) and Siblings (# in college).
What college do you plan to attend?
Estimated cost of one year: Have you been accepted No
What is your intended major?
What financial concerns, now or possibly in the future, may create an obstacle for you to
attend college. (In no more than fifty words):
What scholarships, grants, etc., have you been awarded? And for what amount?
Write a personal (statement) essay about your future goals to add to the
High school students need to request a transcript be added to the
application when returned to the high school guidance office. College
students will need to add a college transcript (or copy of grades to date)
for each scholarship they are applying for. We cannot duplicate college
High School students should complete enclosed form for activities.
College students should attach their own page of college activities and
Some scholarships, (indicated with an * mark on the front page), require
additional information to be included with the application.
9 10 11 12 Awards/Honors/Recognition
Hall of Fame
Modern Foreign Language
National Honor Society
COMMUNITY SERVICE INVOLVEMENT
CARROLL UNIFIED SCHOLARSHIP ADDITIONAL FORM
Perry Township School Memorial Scholarship
Attach two references; one from a teacher, coach/advisor and/or a church pastor
Deadline – March 1