Sons of Norway Vegas Viking Lodge 6-152

Sons of Norway Vegas Viking Lodge 6-152

2010 Scholarship Application

You must be of Norwegian descent; a legal resident of Clark County, Nevada, or a member of the Vegas Viking Lodge or child or grandchild of a member of the lodge; at least a senior in high school; and you must maintain full-time student status to be eligible for this scholarship. The scholarship value is at least $500 and must be used for post-high school studies. Please print or type all information. All questions must be answered or designated as N/A if not applicable. Failure to answer the questions on this three-part, three-page application may negatively affect its evaluation.

Part I - Personal information:

Name:______Email______Birth date: ______

Address:______Phone Nos.:______

Father's name:______Mother's name:______

Address:______Address:______

______

Phone: ______Phone: ______

Total family income from all sources: ___Below $15,000 ___; $15,000 - $30,000;

___$30,000 - $45,000; ___$45,000 - $60,000; ___ $60,000 - $75,000; ___$75,000 -$90,000;

___ $90,000 - $105,000; ___$105,000 - $120,000; ___$120,000 - $135,000; ___above $135,000

This application and the following attachments must be postmarked no later than

April 20, 2010, and sent to the Vegas Viking Scholarship Committee, Chair Erik Pappa, 7313 Bosky Springs St., Las Vegas, NV89131 in order to be eligible for selection:

A. Transcript(s) of grades from this year and cumulative grades to date.

B. A photocopy of your driver's license or other photo identification.

Under penalties of perjury, I declare that I have examined this application, accompanying attachments and statements and, to the best of my knowledge and belief, they are true, correct and complete. I also understand that the information contained in this application is subject to verification by the Sons of Norway Vegas Viking Lodge and that any information found to be false or inaccurate may result in the denial or cancellation of any scholarship award and the requirement to return to the Sons of Norway Vegas Viking Lodge any funds awarded.

Signature______Date:______

Part II - Scholastic and financial information:

1. Describe how you are of Norwegian descent: ______

2. What is your cumulative, unweighted grade-point average based on a 4.0 scale:_____

3. Describe what college, university or technical school (not necessarily in Clark County) you wish to attend along with your major, area of study and career objectives: ______

4.List all extra-curricular activities you have been involved in during the past three years: ______

______

______

5. Do you need to work to attend school:______

6. If currently employed, please provide this information: Employer:______

Hours per week: ______Annual salary: $______

7. Father's employer: ______Mother's employer:______

Address:______Address:______

______

Job title:______Job title:______

How long:______How long:______

Annual salary:______Annual salary:______

8. How many children in your family live at home?______Do you live at home?____

9. Do you have dependents?______If yes, how many?______

10. How many of the children in your household, other than you, are now attending college? ____

Part III – Essay:

Print or type a brief essay on the reasons you are applying for this scholarship, how it will benefit you and any other extenuating circumstances that could help the Sons of Norway Vegas Viking Lodge determine your need for a scholarship. Limit the essay to the space provided on this page and the next. If you use a word processor, your essay must be no more than two pages in length,1.5 or double-spaced, in 12-point font.

The Vegas Viking lodge ( ) was organized in May 1992 and has been involved in a wide variety of special events featuring traditional and contemporary programs having a Norwegian-American flavor ever since. As part of the Sons of Norway, it is a fraternal benefit and cultural society dedicated to preserving Norwegian heritage in North America and strengthening the ties between North America and modern Norway. Vegas Viking also helps charities through donations.