NHS SCHOLARSHIP APPLICATION FORM

							NHS 2010 SCHOLARSHIP APPLICATION FORM                                                     Rank in Class__________(for office use)


DEADLINE: Completed Form to be submitted to the Principal’s office by 3:00 PM on Friday, March 12, 2010
                        (Note: Incomplete applications and applications received after 3:00 PM will not be accepted.)


        Name __________________________________________________________________________________________
                      Last                         First                        Middle
        Address_________________________________________________________________________________________

        Email Address ___________________________________________________________________________________

        Date of Birth ____________________________________________________Phone __________________________

        Name of Parent/Guardian__________________________________________________________________________

        What College/school do you plan to attend? 1st Choice -________________________________________________

        2nd Choice-____________________________________3rd Choice-_______________________________________

        College Addresses________________________________________________________________________________
                                                     City                         State

        2 or 4-year college? _____________Have you been accepted to the above college? ___________________________

        Planned major? _________________________________              For what occupation? ____________________________

        Total College costs per year: __________________Tuition:_________________          Room & Board______________

        Have you been awarded other scholarships or grants? ________________________________________________

        Amount_____________________________________                       Source______________________________________

        What is the estimated total of any other expenses (books, travel)? _______________________________________

        Do you currently have a part-time job? ____________________________________________________________

        Were you employed during the past summer vacation? _______________________________________________

        Do you plan to work during this next summer vacation? ______________________________________________

        How many children are in your family? ____________________________________________________________

        If one or both of your parents are deceased, or you were raised in a single parent home. Please check__________


        For what scholarships are you applying? Circle the numbers of the scholarships for which
        you are applying as listed in the Scholarship Book.
        1   3   4   5    6   7   8       9 10 11 12 13 15 16 17 18 19 20 21 22 23 24 25 27 30 31                 32 33 34

        35 36 37 38 39 40 41 42 43 47 48 49 50 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66

        67 68 69 70 71 72 73 75 76 77 78 79 80 81 82 83 84 85 87 91 92 93 94

        For what supplemental scholarships are you applying? Circle the letter of the scholarships
        for which you are applying as listed in the Supplemental Scholarship Book.
        A   C       D   E    F       G    H   I   J   L   M   N   O   P    Q
                                (TURN OVER)
                                                                    PAGE TWO

BELOW EXPLAIN YOUR PARTICULAR NEED FOR SCHOLARSHIP HELP. (TYPED ONLY)




PLEASE LIST YOUR SCHOOL/COMMUNITY ACTIVITES. (TYPED ONLY)