HOOVER-KOKEN FOUNDATION, INC.
STUDENT APPLICATION FOR GRANT-IN-AID
(Application Deadline: May 1)
Please attach a transcript of your previous year's high school or college credits, whichever applies.
Mail to:Hoover-Koken Foundation, Inc.
811 North Washington Street
Junction City, KS 66441
Phone No.: 785-238-3126Fax No. 785-238-1717
Email Address:
APPLICANT INFORMATION
Name in full ______Social Security Number ______
Home Address ______City/State/Zip Code ______
Phone Number ______
Birth Date ____/_____/_____Male ______Female ______
EDUCATION STATUS
Graduate of ______High School Year ______
College Classification ______Major ______Minor ______
College or trade school you plan to attend (or are attending):
______Name
______Address/Aids & Awards Office
______City/State/Zip Code
Vocational objective ______
Starting Date ______Date of Graduation ______
Note: If you have attended college and are not in attendance at the present time, please explain:
______
Briefly, summarize your school, church and/or community activities. List any organizations to which you belong and offices you have held.
______
______
______
______
______
Commute ( )Live on Campus ( )Other (specify) ______
Anticipated College Major(s) ______
Briefly outline your job/career goals
______
______
______
EXPENSES AND RESOURCES
Awards are given on the basis of financial need and scholastic potential. Study carefully the latest catalogues from the school of your choice in completing the budget.
Application period beginning ______and ending ______
(All applications are for a maximum of 12 months only.)
ExpensesResources
Fees and tuition______Personal savings______
Books and supplies______Earnings ______
Room/Board______Aid from parents______
Clothing______Aid from Scholarships
Personal & and Grants______
Recreation______Other resources (specify)______
Other______
Total______Total______
Indicate what you are doing or will be doing to help meet your anticipated college expenses. Include how you have earned or saved money and what your plans will be for the coming summer.
______
______
______
REFERENCES
Please give three adult, non-relatives, as references. List one teacher or faculty member from last school attended.
Name Address Position
______
______
______
PARENT OR GUARDIAN INFORMATION
Name(s) in full ______
I live with: ( ) Mother ( ) Father ( ) Step-mother ( ) Step-Father ( ) Other ______(please specify
Permanent Home Address ______
Father’s Occupation ______Employer ______Address ______
Mother’s Occupation ______Employer ______Address ______
Children older than you ______Younger ______Total number in family ______
Total Family Income: (Check One)
Under $20,000 ( )$20,001 - $27,500 ( )$27,501 - $35,000 ( )$75,001 - $100,000 ( )
$35,001 - $42,500 ( )$42,501 - $50,000 ( )$50,001 - $75,000 ( )$100,000 - Up ( )
Are there any special family financial considerations you wish the scholarship committee to be aware of?
______
______
______
______
_
I hereby authority the representatives of the Hoover-Koken Foundation, Inc., Junction City, Kansas, to make any financial investigation that is necessary in connection with this application. This may include information from the Social Security Administration, Veterans Administration, Welfare Department and financial institutions such as banks, building and loan companies, etc.
______
Signature - Applicant
______
Signature - Parent
Date ______
Hoover-Koken:APPLICATION.5-19-09
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