<p> APPLICATION FOR SCHOLARSHIP LESCHE WOMAN’S CLUB DALTON, GEORGIA 2017</p><p>Name______</p><p>Permanent address______</p><p>City/State______Zip______</p><p>Phone______Date of Birth______</p><p>Name of parents or guardians______</p><p>Mother or Father’s address if different______</p><p>City and State______Zip______</p><p>Father’s place of employment and title ______</p><p>Mother’s place of employment and title______</p><p>Number of siblings and age of each______</p><p>EDUCATION:</p><p>Name of high school______</p><p>Date of graduation______</p><p>Number in graduating class ______Your rank ______</p><p>Unweighted GPA ______Weighted GPA______</p><p>Academic honors received in high school______</p><p>______</p><p>College you plan to attend______Have you been accepted at this college? ______</p><p>Intended Major______Minor______</p><p>Lesche Scholarship Application, 2016 1 ACTIVITIES AND INTERESTS:</p><p>School activities and sports in which you participated ______</p><p>Community service (volunteer) and church activities______</p><p>FINANCIAL NEED:</p><p>Did you earn any money from part-time work during your high school years?______</p><p>If yes, describe the type of work and indicate the approximate number of hours you worked each week______</p><p>How do you plan to finance you college education (work, financial aid, other scholarships)? ______</p><p>PLEASE BE CERTAIN THE FOLLOWING INFORMATION IS ATTACHED and check when attached: ___ High school transcript</p><p>___ Letter of recommendation from counselor or teacher</p><p>___ 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.</p><p>___ Recent photo (optional)</p><p>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 :</p><p>Sherrian Hall, 202 Auburn Drive, Dalton, GA 30720</p>