AMERICAN LEGION JOHN TAGUE POST #188

2012-2013 SCHOLARSHIP APPLICATION

Two $1,000 Scholarships will be awarded annually.

One of them must go to a Graduate of the New Lexington High School.

Note: All information must be typed.

Student’s Full Name: SS#

Students Address

CityState Zip

Phone email

Date of Birth Place of Birth

Father’s Name Age

Occupation

Mother’s Name Age

Occupation

MILITARY SERVICE

Is any parent or grandparent an Honorably Discharged Veteran of the United States Military?

YES NO

Veteran’s Name Branch of Service

Is any parent of grandparent a member of the New Lexington American Legion Post #188?

YES NO

List ALL schools attended (grades 9-12)

Name Period Attended

Name Period Attended

Name Period Attended

Date of Graduation # of students in graduating class

You must include a copy of your SAT College Entrance Examination

or ACT American College Testing Program scores or equivalent with your application.

SCHOLASTIC ACHIEVEMENTS

  • Scholastic Honors and Awards Received: (State year and nature of award)
  • Scholastic Organization Offices held and positions of leadership: (State name of organization, position & years)
  • Other School Organization Memberships (State name of organization and year, list only major activities)

EXTRA-CURRICULAR (School Related)

  • Honors and Awards Received: (State year and nature of award
  • Organization Offices held and positions of leadership: (State name of organization, position, & year )
  • Other Organization Memberships (State name of organization and year, list only major activities)

Civic (Non-School Related)

  • Honors and Awards Received: (State year and nature of award)
  • Organization Offices held and positions of leadership: (State name of organization, positions & years)
  • Other Organization Memberships (State name of organization and year, list only major activities)
  • State your plans for enrollment in an accredited American technical school, college, or university
  • Have you been granted scholarship aid?

YES NO

If yes, give details

  • Do you intend to apply for financial aid at the college you plan to attend?

YES NO

If yes, give details

  • Do you have reason to expect scholarship aid from any other source?

YES NO

If yes, give details

  • Positions held in gainful employment, periods of employment, average time employed each week, earnings, savings, etc.
  • Any additional data to show financial need and general worthiness. Be specific

Signature Date

FINACIAL ANALYSIS

ALL INFORMATION CONFIDENTIAL

Include a copy of your families 2012 Federal Income Tax Return

  • Non-Taxable Income:

*Social Security Benefits $

*Other Non-Taxable Income

(Child Support, Welfare, etc) $

  • Number of Dependents in college
  • Emergency Expenses not covered by insurance (flood, fire, etc.) $
  • Total market value of home (s) $
  • Amount of unpaid mortgage (s) $
  • Value of Bank Accounts $

Please explain any unusual financial circumstances:

Signatures:

FatherDate

Mother Date

Guardian Date

ALL APPLICATION MUST BE ACCOMPANIED BY

A 500-1000 WORD ESSAY ON

“What would you do to help offset our Gas & Oil prices in the world today?

No late applications will be accepted!

INCOMPLETE APPLCATIONS WILL NOT BE CONSIDERED

APPLICANTS WILL BE INTERVIEWED BY A COMMITTEE FROM POST #188