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.
| 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 |
o
High School Transcriptso
SAT I, SAT II or ACT scoresAre 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.
Please use the back of this page or another sheet of paper for additional space to answer these questions if needed.
Applicant #------------------
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
Amounts offered: Scholarships range from $250.00 - $500.00.
Requirements:
Two awards will be given:
1) One for a Monroe-Woodbury High School Varsity Softball player that has
played at least one year in the senior division of the MWGSL.
One for a non-school ball player, that has played a minimum
of two years in the MWGSL, at least one year in the senior division.
2) Must be a female graduating senior with intentions of going to college.
3) Minimum overall GPA of 2.75
Deadline: All applications must be postmarked by January 15th of
the year that you are graduating.
Additional awards may be given if the fund treasury allows. Information:
774-3792
Return applications to:
Hank Werner Memorial Scholarship
C/O MWGSL
PO Box 297
Monroe, NY 10949
Or:
Monroe Woodbury High School
Guidance Department
Hank Werner Memorial Scholarship
155 Dunderberg Road
Central Valley, NY 10917
MWGSLHWS2006
Revised 11/30/05