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									                       APPLICATION FOR EDUCATIONAL LOAN

                              Ensign Mayo – High Twelve Loan Fund

     Job’s Daughters            Rainbow for Girls         DeMolay               Master Mason

A principal objective of the California Association of High Twelve Clubs is the support of free
public schools. Another objective is the welfare of the Order of Job’s Daughters, Rainbow for
Girls, DeMolay and Master Masons. In 1953, the Ensign Mayo High Twelve Loan Fund was
established by Mr. and Mrs. Frank V. Mayo, adopted by the California Association of High
Twelve Clubs and became another of its educational enterprises and objectives.

This Loan Fund honors worthy and qualified Job’s Daughters, Rainbow for Girls, DeMolay and
Master Masons whose college education may depend partially upon financial assistance. This
Loan Fund is a Masonic source of such assistance. The Fund offers interest-free loans with the
maximum of $4,000 as determined by the Board of Trustees. The amount will be contingent
upon individual needs as well as available funds. Loans are for trade school; undergraduate and
graduate work with a maximum total of loans for five school years. Your high school transcript
must show a 3.0 or better grade point average (GPA), or your trade school or undergraduate
transcripts must show a 3.0 or better GPA, or your graduate transcript must show a 3.0 or better
GPA. You MUST be a full-time student. As an undergraduate student, you must maintain a
minimum of 12 units per quarter or semester.

PLEASE NOTE: School attendance and units carried must be confirmed each year. Official
transcript verifying GPA is required each year for renewal of loans. Without the confirmation of
attendance, loan repayment procedures are automatically instituted sixty (60) days after
completion of term or semester.

I hereby request consideration of a loan from your Trust Fund and submit the following

1. Name _____________________________________________________________________________
               (First Name)                 (Middle Name)                (Last Name)
2. Address ___________________________________________________________________________
               (No. and Street)             (City)               (State) (Zip Code)

3. Mailing Address (if different from above)
              (No. and Street)               (City)              (State) (Zip Code)

4. College Residence Address
                (No. and Street)           (City)                (State) (Zip Code)

5.   Home Telephone ( ____) ______     Business Telephone (___)______ FAX No. (___) ________

6.   Email address: _______________________
                                                                             Page 1 of 4

7. U.S. Citizen?     Yes          No         Date of Birth ________ Place of Birth __________

8. Social Security No. _________________        9.   Driver’s License No. __________________

10. Marital Status __________ Spouse’s Name _______________ No. of dependents________

II. PARENT(S)                     GUARDIAN            (If applicable)

2. Name _____________________________________________________________________
            (First Name)      (Middle Name)           (Last Name)
2. Address ___________________________________________________________________
            (No. and Street)        (City)            (State) (Zip Code)

7. Home Telephone ( ____) ______ Business Telephone (___)______

     FAX No. (___) ________            Email address: _______________________

8. Occupation_________________________________________________________________

1. Name of College or School ____________________________________________________

2. College or School Address
             (No. and Street)       (City)            (State) (Zip Code)

3. Current Status:     Freshman           Sophomore            Junior       Senior

4. Intended College Major Study/Vocation _________ Planned Graduation Date _______

9.    Graduate Study Plans (to include number of years required for a Master’s Degree)

1. Attach all official transcripts form applicable schools/colleges.
2. Submit a minimum of two (2) letters of recommendation with your application
3. You MAY include any additional remarks and/or documentation you deem appropriate.

                                                                        Page 2 of 4
The information you provide should be a realistic anticipated budget of your financial condition.
Fill in ALL applicable blanks in Sections A and B for the CURRENT year.

A. CURRENT SCHOOL EXPENSE (Budget Estimate): $ _________ (Itemized Below)

Tuition and Other College Fees
Text Books and Lab Fees
Room and Board
Clothing and Laundry
Personal Incidentals
Support of Family or Spouse

B. CURRENT YEAR SOURCES OF INCOME $ _________ (Itemized Below)

Monetary Gifts
Other Loans
Funds on Hand
Miscellaneous Income

               C. CURRENT TOTAL INDEBTEDNESS                         $ _________

                D. Who is responsible for your debts while enrolled in School?

           SELF         PARENTS/GUARDIAN                 SPOUSE            OTHER

E. AMOUNT OF LOAN YOU ARE REQUESTING                     $___________________
          (Loan amount not to exceed $4,000)

                                                                           Page 3 of 4
                                    VI. MASONIC AFFILIATION INFORMATION
NAME and NUMBER and LOCATION of your Bethel, Assembly, Chapter or Masonic Lodge
 (Name)                             (Number)                               (Location)


I promise that I will not engage in any conduct unbecoming to a member of the Order of Job's Daughters,
Rainbow for Girls, DeMolay or Master Mason and that any commitment of grant of credit to me for my
benefit may be terminated should I engage in and be found guilty of conduct unbecoming to or in violation of
any of the teachings and covenants I have made as a member of the Order of Job’s Daughters, Rainbow for
Girls, DeMolay or Master Mason.
I have read the above pledge and I fully understand the condition of this loan.

Dated____________________________                      Signed______________________________________
                                                                      (Applicant's Signature)

***********************************For Trustee's Use only**************************************************

ENSIGN MAYO ADVISORY TRUSTEE: I recommend acceptance of this application.

Printed or Typed NAME OF TRUSTEE ______________________________________________________________________
                                        (First Name)         (Middle Name)                (Last Name)
Address:__________________________________________________________________ Telephone No. (___)_______
                 (No. And Street)       (City)       (State)         (Zip Code)
                 (Signature of Trustee)                                      (Date)


ADVISORY BOARD CHAIRMAN_______________________________ DATE _______________________

DATE APPROVED ________________________________


NOTE: After Advisory Trustee approval, application and attached documentation are mailed to:

                                ENSIGN MAYO LOAN FUND SECRETARY
                                             Jerry Saville
                                       22820 Clover Spring Place
                                         Tehachapi CA 93561
                                            (661) 822-8319

                                                                                     Page 4 of 4

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