<p> 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:</p><p>Father’s Name: Employer: Years: Mother’s Name: Employer: Years:</p><p>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)</p><p>College/School Housing: (Mark an X in the appropriate box below) College Dorm On Campus Apartment Off Campus Apartment Commuter</p><p>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)</p><p>Financial Information: Estimated combined household income for 2016: $ May be used by scholarship donors and MT Scholarship Committee to determine financial need.</p><p>Have you completed the FAFSA financial aid application? Yes No</p><p>Will your family be able to contribute toward your college education costs? (please explain) </p><p>Scholarships Awarded: (list the top three) Name: Amount: Name: Amount: Name: Amount:</p><p>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)</p><p>School Athletics Honors Years (which sport) (Team, Individual, All District, etc.)</p><p>Community Activities Years Activity/Participation (include name of organization)</p><p>Dates of Average Hours Work History Position/Responsibilities Employment per Week</p><p>Awards and Honors Year Awarded (such as Perfect Attendance, Leadership Awards, etc.)</p><p>Below, please provide any additional information the selection committee could use in your benefit:</p><p>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)</p><p>School Athletics Honors Years (which sport) (Team, Individual, All District, etc.)</p><p>Community Activities Years Activity/Participation (include name of organization)</p><p>Dates of Average Hours Work History Position/Responsibilities Employment per Week</p><p>Awards and Honors Year Awarded (such as Perfect Attendance, Leadership Awards, etc.)</p><p>Below, please provide any additional information the selection committee could use in your benefit:</p><p>3</p>