HARRY H. TUCKER SCHOLARSHIP FUND

Dear applicant,

The Park Synagogue congratulates you on your approaching high school graduation. To apply for this fund please complete the following information and send to Kenneth Anthony by email to or by mail to:

Kenneth Anthony, Executive Director

Park Synagogue

27500 Shaker Blvd.

Pepper Pike, Ohio 44124

Deadline is June 1, 2012. If you have any questions please call Kenneth Anthony at (216) 371-2244, ext. 136.

There are two parts to this application.

Part I is to be filled out by the applicant.

Part II is to be filled in by your school counselor or a school official. Please fill in your name before you give them the form. (Be sure to inform them that it must be returned by June 1, 2012.) Furnish them with a stamped addressed business envelope to The Park Synagogue, Attn: Kenneth Anthony, 27500 Shaker Blvd., Pepper Pike, OH 44124 – marked Harry Tucker Award.

NOTE:If you also applying for the Joseph & Dora Sharwell ScholarshipFund, pleasecheck here.

PART I

Name of Applicant:

Home Address:

College you will be attending:

Name of Park Synagogue member to whom related:

Your relationship to member:

Graduating High School:

Extra-Curricular Activities:

THE PARK SYNAGOGUE

HARRY H. TUCKER SCHOLARSHIP FUND

PART II

Dear school official, ______is applying for the Harry H. Tucker Scholarship Fund from The Park Synagogue. Please attach a transcript of applicant's grades, CEEB and NMSQT scores, if any.

Please forward this completed form in the self-addressed envelope by June 1, 2012.

Thank you!

Please fill in usingbest scores.

CEEB / SAT / V / M
ACH / EN
NMSQT / SELECTION SCORE:
ACT (IF ANY)

Completed by:

______

name

______

Title

If no self-addressed envelope is included, please mail to:

Kenneth Anthony, Executive Director

Park Synagogue

27500 Shaker Blvd.

Pepper Pike, Ohio 44124