Hank Werner Memorial Scholarship Application

Hank Werner Memorial Scholarship Application  Word Doc.

Please cut and paste this application into a word processing program such as MS Word or Works or print from your browser and complete all the questions as neatly and legibly as possible. Please answer all the questions as completely and accurately as possible. The information on this application is confidential and is available only to the Hank Werner Memorial Scholarship Committee. Print screen button


 
If you do not have access to a computer please send a SASA to:
                                                                                                                MWGSL
                                                                                                                Scholarship Application Request
                                                                                                                 PO Box 297,
                                                                                                                 Monroe, NY 10949

Applicant's Name: Name of High School:
Address: Address:
City/State/Zip: City/State/Zip:
Home phone #: School phone #:
S S Number: Graduating Year:
E-mail address: Applicant #:             Please leave blank

Are you planning on playing softball at the collegiate level? (Optional)  (  ) Yes  ( ) No

 Major you are considering: ________________________________________________

 Colleges to which you plan to apply: _________________________________________

_____________________________________________________________________

 Have you been accepted to any colleges?  (  ) Yes  (  ) No 

If yes, please list the name of the College and address.____________________________

 ______________________________________________________________________

 

SCHOOL AND COMMUNITY REPORT: List below all organizations, clubs and sports in
which you have participated. List any awards you have received while in high school.
Indicate the year and the activity and/or award.
______________________________________________________________________

______________________________________________________________________

SCHOOL AWARDS:
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

COMMUNITY AND/OR VOLUNTEER ACTIVITIES:
_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________ 

WORK EXPERIENCE:
_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________ 

ANYTHING ELSE ABOUT YOURSELF THAT YOU WOULD LIKE US TO TAKE INTO CONSIDERATION:
_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Use the back of this for additional information.

Hank Werner Memorial Scholarship Questionnaire.

The aforementioned statements are true and complete to the best of my knowledge. I authorize the committee of this organization to contact any person to verify information or materials cited in this application. I understand that misrepresentation and/or an incomplete application could result in a denial of my application for the scholarship requested.

 

___________________________________________                             __________

Applicant’s Signature                                                                                          Date

Print name__________________________________

 

Office Use Only:

Date Application Received:                                           By                                                      

 MWGSLHWS2006
Revised 11/30/05