THE FLORIDA SOCIETY
COLONIAL DAMES XVII CENTURY
ANNE MASSEY GENERAL SCHOLARSHIP
Deadline: April 1, 2016
Amount: $1000.00
Date: ____________________ HighSchool__________________________________________________
Name:________________________________________________________________________________
Address:______________________________________________________________________________
Phone:________________________________Email___________________________________________
Date of Birth___________________________________ Social Security #__________________________
College accepted by and address:__________________________________________________________
Estimated total coast of schooling year_____________________________________________________
How much can applicant provide of his/her expenses?_________________________________________
Savings for College______________________________________________________________________
Father’s occupation_____________________________________________________________________
Mother’s occupation____________________________________________________________________
Name and ages of dependents in family other than applicant___________________________________
We attest that all information in this application and
all attachments constitute a true and accurate record.
_________________________ __________________________ ___________________
Signature of Father Signature of Mother Signature of Applicant
The following are also required:
1. Copy of college acceptance by a Florida 4 year accredited College/University a 2 year accredited Florida Community College.
2. Extra-curricular activities
3. A one page summary of aims, ambitions and why you need financial aid.
4. Copy of transcript record (with GPA of 3.0 or higher)
5. Recommendation from a teacher or principal and one other non-family member
6. Plan to attend college full time before the end of the calendar year
RETURN TO: Anne Massey Scholarship, Chapter Chairman
Name: Sylvia Walden
Address: 31508 Ave F
Big Pine Key, FL 33043