Application for Scholarship

APPLICATION FOR SCHOLARSHIP LESCHE WOMAN’S CLUB DALTON, GEORGIA 2017

Name______

Permanent address______

City/State______Zip______

Phone______Date of Birth______

Name of parents or guardians______

Mother or Father’s address if different______

City and State______Zip______

Father’s place of employment and title ______

Mother’s place of employment and title______

Number of siblings and age of each______

EDUCATION:

Name of high school______

Date of graduation______

Number in graduating class ______Your rank ______

Unweighted GPA ______Weighted GPA______

Academic honors received in high school______

______

College you plan to attend______Have you been accepted at this college? ______

Intended Major______Minor______

Lesche Scholarship Application, 2016 1 ACTIVITIES AND INTERESTS:

School activities and sports in which you participated ______

Community service (volunteer) and church activities______

FINANCIAL NEED:

Did you earn any money from part-time work during your high school years?______

If yes, describe the type of work and indicate the approximate number of hours you worked each week______

How do you plan to finance you college education (work, financial aid, other scholarships)? ______

PLEASE BE CERTAIN THE FOLLOWING INFORMATION IS ATTACHED and check when attached: ___ High school transcript

___ Letter of recommendation from counselor or teacher

___ Your personal letter or essay giving information about yourself, your plans, your goals, your dreams, and how this scholarship would help you achieve your goals.

___ Recent photo (optional)

Student’s Signature______Date______(This form may be expanded to accommodate more material. An attachment with more information is accepted.) Applications should be mailed to the following address and are due by April 1 :

Sherrian Hall, 202 Auburn Drive, Dalton, GA 30720