1. / Last Name: / First Name:
2. / Mailing Address:
Street:
City: State: ZIP:
3. / Daytime Telephone Number: ( )
4. / Date of Birth: Month Day Year
5. / Current High School: / Number of years
attended:
6. / I am planning to attend the following school in the Fall of 2013:
Proof of enrollment and registration is required prior to receipt of funds.
7. / Name & address of parent(s) or legal guardian(s): Use reverse side of application if you need more space.
Name(s):
Address:
Home phone of parents or legal guardians:
8. / Name and city of other high schools attended: / Number of years attended:
9. / What specialty / major do you plan to major in as you continue your education?
10. / What did you learn about yourself as a member of the RHAM Football Program?
11. / List your academic honors, awards and membership activities while in high school:
12. / List your community service activities, hobbies, outside interests, and extracurricular activities:
13. / Personal Essay
Please submit a short (250-350 words) typewritten and double-spaced essay on the subject ;
"My Future Goals and How my time spent at RHAM High School and/or my community involvement has helped shape those goals."
Attach your typewritten essay to the application.
14. / A. The following items must be attached to this application in order for the application to qualify to be reviewed by the scholarship committee.
B. Your application will be returned to you if these items are not attached to this application. (No exceptions.)
C. Circle “YES” or “NO” to be sure you have attached each item as required.
YES / NO / Completed Application Form
YES / NO / One (1) professional letter of recommendation. Return the letter of recommendation in a sealed envelope
YES / NO / Most recent official high school transcript. Photocopies of your transcript are not acceptable
YES / NO / Personal Essay.
MORAL STATEMENT OF ACCURACY
I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that my picture may be taken and used for any purpose deemed necessary to promote the Friends of RHAM High School Football Scholarship Program.
I hereby understand that if chosen as a scholarship winner, I must provide evidence of enrollment / registration at the post-secondary institution of my choice before scholarship funds can be awarded. Furthermore, I understand this scholarship shall only be used for college related expenses.
Signature of scholarship applicant: Date: