2017 Miami Trace Scholarship Application

2017 Miami Trace Scholarship Application **Deadline March 31, 2017 at 3:00 p.m.** **Application must be typed or printed neatly in ink** Student Information: Student Name: GPA: Class Rank: Address: Phone: Email: City: Township: Zip:

Father’s Name: Employer: Years: Mother’s Name: Employer: Years:

School Information: High School Course of Study: (Mark an X in all that apply) Honors Diploma Advanced College Prep STEM General Ed. Career Tech. Intended College/School: Intended Major: Have you applied? (yes or no) Have you been accepted? (yes or no)

College/School Housing: (Mark an X in the appropriate box below) College Dorm On Campus Apartment Off Campus Apartment Commuter

Sibling Information: Name: Age: School (if currently attending) Name: Age: School (if currently attending) Name: Age: School (if currently attending) Name: Age: School (if currently attending) Name: Age: School (if currently attending)

Financial Information: Estimated combined household income for 2016: $ May be used by scholarship donors and MT Scholarship Committee to determine financial need.

Have you completed the FAFSA financial aid application? Yes No

Will your family be able to contribute toward your college education costs? (please explain)

Scholarships Awarded: (list the top three) Name: Amount: Name: Amount: Name: Amount:

1 2017 Miami Trace Scholarship Application **Deadline March 31, 2017 at 3:00 p.m.** **If more space is needed, continue on page 3** School Activities, Clubs, Level of Participation Years Offices or Committees/Leadership Organizations (local, state, national)

School Athletics Honors Years (which sport) (Team, Individual, All District, etc.)

Community Activities Years Activity/Participation (include name of organization)

Dates of Average Hours Work History Position/Responsibilities Employment per Week

Awards and Honors Year Awarded (such as Perfect Attendance, Leadership Awards, etc.)

Below, please provide any additional information the selection committee could use in your benefit:

2 2017 Miami Trace Scholarship Application **Deadline March 31, 2017 at 3:00 p.m.** Please do not submit this page if it is blank School Activities, Clubs, Level of Participation Years Offices or Committees/Leadership Organizations (local, state, national)

School Athletics Honors Years (which sport) (Team, Individual, All District, etc.)

Community Activities Years Activity/Participation (include name of organization)

Dates of Average Hours Work History Position/Responsibilities Employment per Week

Awards and Honors Year Awarded (such as Perfect Attendance, Leadership Awards, etc.)

Below, please provide any additional information the selection committee could use in your benefit: