VINCENT LOMBARDI LODGE #2270

SCHOLARSHIP APPLICATION FORM

Name: (First)______(MI)______(Last)______

Address: ______

City: ______State: ______Zip Code:______

Phone Number:______E-Mail Address:______

Fathers Name: (First)______(MI)______(Last)______

Fathers Address: ______

Mothers Name: (First)______(MI)_____(Maiden)______(Last)______

Mothers Address: ______

EDUCATIONAL SUMMARY

Name of High School Currently Attending: ______

Address: ______

City: ______State: ______Zip Code: ______

Phone Number: ______

Name of Guidance Counselor: ______

Anticipated date of Graduation: ______

Name of College or University to which student has applied for attendance for Fall 2007:

______

Name of College or University where applicant has been accepted for Fall 2007:

______

Name of College or University where applicant has not been accepted for Fall 2007:

______

Name of College or University where application is still pending for Fall 2007:

______

VINCENT LOMBARDI LODGE #2270

SCHOLARSHIP APPLICATION FORM

I. Please submit a 500 word typed essay, double spaced on the following topic:

  1. Discuss the values and contributions made by Italians to American culture and society.
  2. What it means to you to be of Italian-American heritage.
  3. Include your future goals and aspirations including your major and minor fields of academic study.

II. Please submit your current resume of extra curricular activities, work experiences, volunteer service , honors, etc.

III. Please have your high school guidance counselor submit an official sealed transcript of your high school courses and grades including test scores such as SAT or ACT.

IV. Have three letters of recommendation submitted, including one by applicant’s high school guidance counselor sent directly to Professor Joseph Berta, address below.

It is the responsibility of the scholarship applicant to assure that all requested information is submitted to the Vincent Lombardi Lodge #2270 Scholarship Committee Chairperson by the deadline date of March 31, 2007 including the information requested of your high school guidance counselor. Applications or materials received after the deadline date of March 31, 2007 will not be considered for the scholarship.

Please submit your scholarship application, requested materials to:

Professor Joseph Berta

10 Debran Drive

Henrietta, New York 14467

585-334-6641