APPLICATION FOR
CONNIE BENNETT HOLLAND
MEMORIAL SCHOLARSHIP
$500.00 – SPONSORED BY SANDY RIDGE PTA
A. Scholarship Applicant Information
Name:______Birth Date: ______
( last ) ( first ) ( middle )
Permanent Address: ______
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Telephone Number: ( ) .
B. Parent(s) / Guardian’s Name
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Permanent Address: ______
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Telephone: (work)______(home) ______
Relationship to Applicant: ______
C. Post Secondary Institution for which scholarship is requested
Name of college: ______
College Address: ______
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Type of Post Secondary Education Institution (2 year college, 4 year college, vo-tech, nursing, etc.)
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Admission Status:
Accepted: ______Pending: ______
D. School Activities and Honors:
(Give a complete description of all scholastic honors and activities and state the year or years in each case.)
Academic Honors won in high school: ______
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E. Extracurricular Activities and any other Honors won in the last four years (include class office, membership in organizations, athletic achievements and all other membership and offices held, including church and community activities as well as part-time or summer jobs you have held).
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F. In your own words and handwriting, explain your educational and career aspirations and goals for the future. (Explain why you decided to pursue a post secondary educational program, why you selected the institution chosen, and what you expect to achieve.)
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G. Please explain any other personal circumstances you feel should come to the attention of the selection committee.
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( signature of applicant ) ( date )
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(signature of parent/guardian) ( relationship ) ( date )
Return completed application to NSHS guidance office by: February 27, 2009