With this application, please include a copy of the following by tamir13


									                                                        “ Investment in Education ”



a) The applicant need be enrolled for Associate /under Graduate, or Graduate studies in an
   accredited College or University.

b) The student or his/her family need be a member of Krokeai Society for two years ( current
   and past ).

c) Past Educational Award winners are not eligible.

Name of Applicant: _____________________________________________________________

Address ______________________________________ City/Town _______________________

State: _______ Zip Code: ___________ Telephone Number: (______) - _________________

Father’s Name____________________                Mother ‘s Maiden name ________________________

Date of Birth: _____________________              Year of Graduation      _______________________

College or University _______________________ City ______________________State _______

Please include a copy of the following documents.

       1. College or University student ID card or enrollment letter.
       2. Self or Family proof of membership or membership dues ($25).

              (Please note: You must be a member of the society for at least 2 years
              in order to be eligible to participate. You may submit current and past year
              dues with this application. )

Application and supporting documents need to be received before June 20
You may also bring your application and documents to our Convention in person.

Applicant’s Signature                        _     __                          Date    ____________

Please mail to: KROKEAI SOCIETY C/o Nick Merianos
                135 Manthorne Rd. West Roxbury, MA 02132

              If you have any questions please call us at (617) 327-2503 or (617) 784-0657

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