Mouzon R. Tiller Scholarship Social Security Number______

Mouzon R. Tiller Scholarship Social Security Number______

Return to Counselor by middle of MARCH

MOUZON R. TILLER MEMORIAL SCHOLARSHIP

Mouzon R. Tiller was a resident of Elysian Fields and was a rancher, cattleman, civic leader, and supporter of local education. He was married to Frances Wellborn Tiller who was a teacher in the Elysian Fields ISD for 34 years. Mr. Tiller was a person of strong faith who cared very deeply for his family, his community, and the future leaders of tomorrow.

Scholarship Application

Personal Information:

Name / Phone
Street Address or P.O. Box / Social Security Number
City, State, ZIP

Academic Information:

ACT/SAT Score: ______/ Class Rank ______of ______/ GPA ______
College/Vocational School:
Major or Area of Study:

Organizations / Sports / Activities Involved In:

In the space provided below, explain why you should be the recipient of the Mouzon R. Tiller Memorial Scholarship.