High School Scholarship Application Form

Sherri Madson Scholarship Application (2018-2019)

The information provided on this form will be used by the High School Scholarship Committee to select recipients for scholarships. It is important that you give complete details concerning your college/career plans, activities and financial information. Applications are due May 1, 2019 at 5:00pm.
BASIC INFORMATION
Student's Full / Legal Name*

First NameLast Name
Student ID:*
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Phone Number*

Area CodePhone Number
Student E-mail*
Student Birth Date

MonthDayYear
Gender

Academics
Academic GPA*
Schools to which you are applying
School 1
School 2
School 3
School 4
Will Live
Major(s) You Are Considering

In order of preference, list the major(s) you are considering (Very important for scholarship eligibility).
Major 1
Major 2
Major 3

REFERENCES:

Please list one educator and at least one community person who would recommend you for a scholarship. Please do not list the person who completes a scholarship recommendation for you.
Reference 1 (Name, Position,Phone Number)
Reference 2 (Name, Position,Phone Number)

SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

List name of club, etc. and years of participation. If you volunteered, list the name of organization and the number of hours, weeks and years that you volunteered. If you worked, list the company, hours per week and length of time. Attach an additional sheet or resume if necessary.
What School Do You Attend?
Are You A Senior?

YesNo
School Activities / Offices Held 1: (not sports)
School Activities / Offices Held 2: (not sports)
School Activities / Offices Held 3: (not sports)
School Activities / Offices Held 3: (not sports)
Community Service / Volunteer Activities 1 (outside of school)
Community Service / Volunteer Activities 2 (outside of school)
Community Service / Volunteer Activities 3 (outside of school)
Sports Participation 1
Sports Participation 2
Sports Participation 3
Will you be participating in a sport(s) this year?

YesNo
What Sport?
School / Community Awards and Honors 1 (no matter how small) CSF, GSE, National Honor Society, Girl/Boy Scouts, 4-H, Governor’s Scholar, etc.
School / Community Awards and Honors 2
School / Community Awards and Honors 3
EMPLOYMENT 1: List past and present work and length of time employed.
EMPLOYMENT 2: List past and present work and length of time employed.

Sherri Madson Scholarship Application (2018-2019)