American Nation Bank Scholarship Application

American Nation Bank Scholarship Application

Total scholarship to be awarded: $1,000

($500 per semester, first year only)

I, ______, will graduate this spring from

______High School and plan to continue my education at a college/university this fall. If I am chosen as a recipient of this award, I must attend a two or four year accredited college/university in the United States approved by American Nation Bank.

Student’s Home Address:

StreetCityStateZip

Parent or Guardian: ______

Telephone: ______

High School Name and Address:______

P.O. Box or StreetCityStateZip

Where and how many years do you plan on attending college/university?______

What is your field of study or major?______

Counselor’s Name:______Telephone ______

Date:______Applicant’s Signature______

American Nation Bank Scholarship

Objective Criteria List

Section A, B and C of this application are to have either the Counselor’s or Principal’s authorized signature where indicated. SectionD, E, Fand G are to be completed by the applicant. A completed ANB Scholarship application form must be received by ANBno later than April 7, 2017. Applications received after April 7, 2017 will not be considered.

Return completed ANB Scholarship applications to:

American Nation Bank, P.O. Box 5009, Ardmore, OK 73403

or your most convenient ANB location.

Section A: Please attach a certified High School transcript including first semester of your Senior (grade 12) year.

Section B: List honors, awards or recognition received your Junior year:

Section C: List honors, awards or recognition received your Senior year:

Student’s Name: ______

Counselor’s or Principal’s Signature:

Date: ______

D: Financial need: In the space provided, please indicate your family’s total adjusted gross income from last year’s tax return.

_____under $20,000_____$35,001 to $50,000

_____$20,000 to $35,000_____over $50,000

Total number of family members living at home: ______

Number of dependents in your parents’ family including yourself:

Children: ______Ages: ______Number attending college: ______

Other financial considerations which need to be noted:

______

______

E: Extracurricular Activities:

Honors and Awards:

Community or Other Activities:

F: Work Activities – Are you now employed Yes _____ No _____

If yes, where, what type of work and how many hours per week?

Do you plan on working while you attend college? Yes _____ No _____

Do you plan on living on campus or commuting? ______

G: In the space provided below, please describe in your own words and handwriting why you would like to be a recipient of the American Nation Bank Scholarship. This should also include the course of study or major field of interest you plan to follow, your proposed occupation or profession and any other abilities you have that were not previously mentioned in this application. Please complete this in 100 words or less.

______

Student’s Signature ______