Lawrence High School 2015 Local Scholarship Application

TO SAVE TIME- if you are applying for multiple scholarships, we recommend that you fill out all sections of this application, exceptfor Section 1, then make the appropriate number of photocopies for each Local Scholarship that accepts this application. On your photocopies write in SECTION 1 the scholarship name of the appropriate scholarship you are applying for.

SECTION 1 – Scholarship Name

Name of Scholarship______

SECTION 2 – Applicant Information

Parent signature required if student is not 18. We agree to release the following information to Scholarship Committees.

Student Name______Student Signature______

Print clearly

Home Address______Parent Signature______

Email Address______Phone______

SECTION 3 – Grade & Test Score Information

Order a copy of your transcript from parchment.com to obtain this information. Attach transcript to ALLapplications.

Unweighted GPA / Weighted GPA / ACT Composite / SAT Reading / SAT Math / SAT Writing

SECTION 4 – Academic Awards & Offices Held, Honors

Awards/Honors/Offices / Description / Grade Level

Extracurricular Activities-including Athletics, Clubs, Fine Arts, Volunteer Work, Special Interests

Activity / Position held, honors,letters / Grade Level

Employment Experience-Grades 9-12 (Begin with most recent position)

Employer / Position Held / Dates of Employment Hrs per week

SECTION 5 -College/University Information

List the post-secondary school you plan to attend next year. If you are considering more than one school,

Please rank them listing your first choice first.

College / Admitted / Waitlisted / Denied / No Reply Yet / Other
Attending:
1
2
3
4

SECTION 6 – Scholarships Awarded

Source / Dollar Amount / Renewable: Yes or No

SECTION 7 - Parent/Guardian/Family Information

(If a scholarship notes demonstration of financial need you must supply income information).

#1 Primary Parent/Guardian Name: ______

Name of Employer______Position ______Yrs. W/Employer______

Gross Annual Income (must be completed for need based scholarships):______

#2 Secondary Parent/Guardian Name: ______

Name of Employer______Position______Yrs. w/Employer______

Gross Annual Income (must be completed for need based scholarships):______

#3 Non-Custodial Parent Name: ______

(If Student’s parents are divorced, separated, or never married to each other.)

Name of Employer______Position______Yrs w/Employer______

Gross Annual Income______

Section 8 – Siblings and Family Members Attending Post-Secondary

Name / School / Grade K-12 / College Student yes or no

Section 9 – Applicant Statements

Write a brief statement about your desire to continue your education include your career goals and intended college major.

Please state any special circumstances which you feel make it imperative that you have financial aid in the form of a scholarship