Scholarship Application The Orrstown Bank Foundation annually awards scholarships to eligible high school seniors attending secondary schools within the core communities that Orrstown Bank serves: Pennsylvania: • Cumberland, Franklin, Lancaster, or Perry Counties – All School Districts • Dauphin County: Central Dauphin School District Derry Township School District Lower Dauphin School District Harrisburg City School District Middletown Area School District Steelton-Highspire School District Susquehanna Township School District Maryland • Washington County – All School Districts General Instructions: Complete the application in its entirety. Submit the application, along with a personal letter of introduction, three letters of recommendation, and an official high school transcript with a school seal to: Scholarship Program, c/o Orrstown Bank, 77 E. King Street, Shippensburg PA 17257, or submit electronically to:
[email protected]. Applications must be postmarked or received electronically no later than Friday, March 31, 2017. STUDENT INFORMATION (Please print clearly) Student's Full Name: Mr./Ms./Mrs. First Name M.I. Last Name Address: Street # and Name City State Zip Email Address: County of Residence: Date of Birth: Telephone number: Social Security #: Name of Parent or Guardian: www.orrstown.com 1 Complete Home Address (if different from application) SCHOOL INFORMATION (Please print clearly) High School Name: Date of High School Graduation: High School Address: Street City State Zip County List academic honors: (Include an additional page, if required) The Institution(s) to which I am applying for admission: Desired major/ area of interest: SIGNATURE AND DATE (required) By signing this document, I hereby submit my application to the Orrstown Bank Foundation for a scholarship. I have read the Orrstown Bank Foundation Scholarship Guidelines and understand the terms and conditions upon which a scholarship is granted.