Untitled Document

Memorial Scholarship
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SCHOLARSHIP FUND LIONS CLUB OF WEST SEATTLE
Secretary’s Office
care of: Dr. James T. Dunham 3255 California Ave. S.W. Seattle, WA 98116

To: SCHOLARSHIP FUND COMMITTEE LIONS CLUB OF WEST SEATTLE

The undersigned hereby makes application to be considered for a scholarship to be awarded in
May 2006

Check one:

______ 4 year college or university
______ Community college

Name ________________________________________________________ Age ___________

Residence Address _____________________________________________________________

Telephone Number _____________________________________________________________

Length of Residence in West Seattle ________________________________________________

High Schools Attended __________________________________________________________

High School
Grade Point Average _____________

College, University
Choice _______________________________________

Intended Major or Vocational Program ______________________________________________

List of School Activities _________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

List of Job Experiences __________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Outside of School Affiliations (Church, Scouts, Clubs, etc.) _____________________________
_____________________________________________________________________________
_____________________________________________________________________________

(Attach Separate Sheet if Necessary)

Memorial Scholarship
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SCHOLARSHIP FUND LIONS CLUB OF WEST SEATTLE
Secretary’s Office
care of: Dr. James T. Dunham 3255 California Ave. S.W. Seattle, WA 98116

Explain your financial need for this scholarship: ______________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

DATED this _______ day of _______________, 2006.

SIGNATURE OF APPLICANT __________________________________________________

You are advised to consult with your school advisers before submitting the completed application.

This application must be accompanied by:

(1) A true copy of your high school scholastic record.
(2) A personal essay describing your life and how you have reached your decision and goal to attend college.
(3) Two letters of recommendation, one from a teacher and one other.

CRITERIA FOR LIONS CLUB SCHOLARSHIPS:

CITIZENSHIP
SCHOLARSHIP

To be returned to the Secretary's office no later than April 15, 2006

(Attach Separate Sheet if Necessary)