North Side High School Alumni Association

2016 North Side Alumni Family Scholarship Application

(forChildren/Grandchildren of Alumni Association Members)

(Due March 2, 2016)

North Side High School Alumni Association

475 E. State Blvd.

Fort Wayne, IN 46805

(260) 471-4499 ~ Email:

General Information:The North Side Alumni Association considers the children and grandchildren of members of the North Side Alumni Association for general alumni scholarships. The number of scholarships available variesyear to year.

Directions: The application will consist of four pages, a copy of the student’s official school transcript and a current picture. Incomplete applications will not be considered. Please send a self-addressed, stamped envelope if you wish the picture to be returned.

Page One:This cover sheet

Page Two:General Information concerning the student (included in this packet)

Page Three:A listing of high school and community activities as well as awards and honors earned during high school (included in this packet)—Please note which year(s) participation occurred.

Page Four:An attached one-pagestudent essay: In your own words, please state your educational and/or personal goals and describe the process that led to their development. Please TYPE your essay.

Please submit your completed application to:
North Side High School Alumni Association, 475 E. State Blvd. Fort Wayne, IN 46805.
Application must be postmarked on or before March 2, 2016.

Student Name: ______

(Please Print clearly)LastFirst M.I.

I am the: (check any that apply)

______Child of a current member of the North Side High School Alumni Association

______Grandchild of a current member of the North Side High School Alumni Association

Name of Alumni Member:______

North Side Class of: ______

I am a graduating senior of the class of 2016 at:

Name of High School:______

Address of High School:______

______

NS Child/Grandchild Alumni Scholarship 2016 - page two

NAME:______

Last FirstMiddle

ADDRESS:______

Number & StreetCity & StateZip

TELEPHONE: (______) ______-______E-Mail: ______

DATE OF BIRTH: ______COMMENCEMENT DATE: ______

MonthDay Year

PARENT/GUARDIAN NAME:______

PARENT/GUARDIAN ADDRESS:______

(If Different from Above)

______

SCHOOL YOU PLAN TO ATTEND

& ITS ADDRESS______

______

______

ACCEPTANCE STATUS AT ABOVE SCHOOL:______ACCEPTED ______PENDING

FINANCIAL CONSIDERATIONS:

Number of Family Members in the Home:______

Number of Family Members in college (Other than Applicant)

full-time for the 2016-17 school year:______

Estimated First Year College Expenses for this student:______

STUDENT SIGNATURE:______

For Alumni Office Use Only: Date Submitted: ______(Staff Initials: ______)

NS Child/Grandchild Alumni Scholarship 2016 - page three

ACTIVITIES - SERVICE - HONORS/AWARDS

Please include the grade-level years (9,10,11,12) in which participation took place

APPLICANT NAME: ______

PART I - HIGH SCHOOL ACTIVITIES AND SERVICE TO THE SCHOOL

HIGH SCHOOL ACTIVITIESSERVICE TO THE SCHOOL

______

______

______

______

______

PART II - COMMUNITY ACTIVITIES AND COMMUNITY SERVICE

COMMUNITY ACTIVITIESCOMMUNITY SERVICE

______

______

______

______

______

PART III - AWARDS, HONORS AND OFFICES HELD

IN THE HIGH SCHOOLIN THE COMMUNITY

______

______

______

______

______