MAIL APPLICATION TO:
P.O. BOX 1583
SANTA ROSA, CAL. 95402-1583
2008 SCHOLARSHIP APPLICATION FORM
STUDENT APPLICANT
Name___________________________________________________________________
Adress__________________________________________________________________
Phone Number_________________
Date and Place of Birth_____________________________________________________
Social Security Number____________________
Schooling Attending Now___________________________________________________
Extracurricular Activities___________________________________________________
(Sports, Clubs, Music, Drama etc.) Attach to this Form
Community Service_______________________________________________________
Class or School Honors. List ________________________________________________
(Attach to this Form)
GPA Score_______________
College or Vocational Training Program to Attend_______________________________
Your Major ______________________________________________________________
Five Hundred Word Essay: This can be on any subject you like.
Student Signature ________________________ Date ____________
Parent Signature __________________________ Date ____________