CI ZIP Letter from your ophthalmologist stating visual by mikeholy

VIEWS: 21 PAGES: 1

									              mE PlllLOMA11IEON SOCIE1Y OF mE BLIND, INC.
                      ANN BLACK SCHOLARSIllP GRANT

NAME OF APPLICANT:                                           BIRnIDATE:


ADDRESS:                                   CI1Y:                    ZIP:

PARENT'S NAMES:

mOH SCHOOLATfEN DED:                                 HOME PHONE:

PRINCIPAL'S NAME:

COUNSELOR'S NAME :

CAREER INTRESTS:



ACADEMIC INTERESTS:




EX1RA -CURRICULAR A CnvIES:



      OF
CHO~CE COLLEGE OR 1EClllNCAL SCHOOL:             ~




ALREADY ACCEPTED: YES:                        NO:


PLEASEUSE OlliER smE OF APPLICAllON TO WRITE A PARAGRAPHABOUT
YOUR GOALS FOR mE FUTURE & WHY YOU FEEL YOU QUALIFY FOR rnIS
GRANT:
PLEASEENCLOSEnrn FOLLO:wlliG:
  1. Transcriptof high schoolgrades.
  2. Lettersof recommendation  from principal and counselor.
                                by
  3. Copy of letter or acceptance collegeor technicalschool,if alreadyaccepted.
                                  stating
   4. Letterfrom yourophthalmologist     visualdisability.      .

          MAIL TO: The PhilomatheonSocietyof the Blind
                    2701 WestTuscarawas Street
                     Canton,Ohio 44708
                                    TO
nus APPLICAnON MUSTBE RETURNEID mE PlllI.,OMAmEON SOCIETYBY:
                       February1,2007

								
To top