2009 Sturgis Falls Scholarship Application Form

Student Information
Name: ______________________________________
Address: ______________________________________
E-mail: ______________________________________
Phone: ______________________________________
Birth Date: ______________________________________
Social Security Number: ______________________________________
Parent/guardian Name(s): ______________________________________

Educational Information
High School: ______________________________________
Graduation Date: ______________________________________
Cumulative GPA: ______________________________________
Class Rank: ______________________________________
Essay
Please attach a separate sheet of paper with a 500-word essay typewritten that relates your career goals to the spirit of the Sturgis Falls Celebration.
Official Copy of Current High School Transcript   
Extra-Curricular Activities and Employment Record
Please attach a thorough list of involvement including years involved, leadership roles, honors/awards, and employment record with business name, supervisor and dates of employment.

References
Please list the names of 3 persons (other than relatives) who you have asked to be references. Include telephone number and how you know each person. These persons may be contacted for verbal references during the selection process.

 

I declare that all the information provided is correct and accurate to the best of my knowledge. If I am granted the Sturgis Falls Scholarship, I agree to submit a grade report for the year that the scholarship was granted.

___________________________________________  ____________________
Applicants Signature                                             Date

___________________________________________  ____________________
Parent/Guardian's Signature                                  Date

Application must be post marked by February 15, 2009