APPL 4 SCHOLAR PG 1 thru 4

							                   APPLICATION FOR SCHOLARSHIPS

NAME_______________________________________________________________________

PREFERRED TITLE               _____ MISS                 _____MR.              ____MRS.

HOME ADDRESS_____________________________________________________________
              (STREET)
_____________________________________________________________________________
(CITY)                                      (STATE)              (ZIP)

HOME TELEPHONE (_____)___________________________________________

BIRTH DATE        MONTH                          DAY             ___YEAR___________________

ARE YOU AN AMERICAN CITIZEN?___________________________________________
ARE YOU A MEMBER OF THE REV. DR. JOHN J. SASS MEMORIAL
FOUNDATION?_______________________________________________________________

IF YES, WHEN DID YOU JOIN? ________________________________________________


PLEASE LIST OTHER ORGANIZATIONS TO WH1CH YOU ARE A MEMBER:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

HOW DID YOU HEAR ABOUT THIS SCHOLARSHIP? ____________________________

______________________________________________________________________________

HAVE YOU APPLIED FOR ANY OTHER FOUNDATION SCHOLARSHIP?
____YES   _____ NO

IF YES, WHICH ONE(S)

_____BOOK SCHOLARSHIP                      _____PERSONAL GROWTH

_____CONTINUING EDUCATION                  _____REV. DR. JOHN J. SASS




PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOUR HIGH
SCHOOL:
NAME AND ADDRESS OF SCHOOL______________________________________
________________________________________________________________________
DATES ATTENDED/ FROM____________________ TO ______________________

DEGREE OR DIPLOMA ____________________CLASS RANK________________

CIRCLE YOUR PRESENT CLASSIFICATION:

High School SENIOR   FRESHMAN     SOPHOMORE       JUNIOR    GRADUATE
WHAT IS YOUR CUMULATIVE GRADE POINT AVERAGE? _______________
WHAT COLLEGES HAVE YOU SUBMITTED APPLICATIONS TO? _________
_______________________________________________________________________
_______________________________________________________________________

HAVE YOU RECEIVED CONFIRMATION OF ACCEPTANCE FROM ANY
COLLEGE(S)    _____ YES _____ NO

IF YES, LIST THE COLLEGES OR UNIVERSITIES AT WHICH YOU HAVE
BEEN ACCEPTED. PLACE AN ASTERISK (*) BESIDE THE ONE YOU WILL
MOST LIKELY ATTEND AND ENCLOSE A COPY OF THE ACCEPTANCE
LETTER. ______________________________________________________________
________________________________________________________________________
________________________________________________________________________

LIST ANY ACADEMIC AWARDS OR HONORS: ___________________________
________________________________________________________________________
________________________________________________________________________
WHAT IS YOUR AREA OF SPECIALIZATION (MAJOR OF STUDY)?
________________________________________________________________________

DATE OF ANTICIPATED DEGREE COMPLETION ________________________

PLEASE DESCRIBE ANY COURSE TAKEN AND OR JOB EXPERIENCE RELEVANT
TO YOUR MAJOR: _________________________________________
_______________________________________________________________________
_______________________________________________________________________
BIOGRAPHICAL SKETCH:
LIST OTHER NON-FOUNDATION MAJOR CIVIC AND SOCIAL ACTIVITIES IN
WHICH YOU HAVE PARTICIPATED.
DESCRIBE THE PURPOSE AND OBJECTIVES OF EACH ORGANIZATION, THE
POSITION YOU HEL D, AND ANY AWARDS OR SPECIAL RECOGNITIONS THAT
YOU RECEIVED. INCLUDE DATES
(ATTACH ANSWER):
EXPLAIN WHAT LED TO YOUR INTEREST IN YOUR PARTICULAR
SPECIALIZATION AND WHAT COURSE YOU ULTIMATELY WISH TO PURSUE.
(ATTACH ANSWERS):