Application Within

Name______________________________________                  Date __________________________________

 

Mailing Address _______________________________________________________________________________

 

Telephone Number (___) ___________________                   Age ___________________________________

 

Briefly describe your financial need (specific tuition amount) and current scholarships: __________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Briefly describe your academic goals (what you plan to do with your degree): ____________________

________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________

 

Briefly describe your interests and/or hobbies: _________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Briefly describe your high school achievements/awards: ________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________

 

Briefly describe your community service and/or volunteer activities:_____________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Training Program Entered: _____________________________________________________________________

 

School/Address of place of training: ____________________________________________________________

________________________________________________________________________________________________

 

Current GPA on a scale of 4.0 (high school students -- as figured through the 7th semester, college students -- as figured through the 1st semester of year of application): ___________________________

 

_____ Full-time student (enrolling in 12 credits or more)

 

_____ Half-time student (enrolling in less than 12 credits)

 

_____ I certify that I have met all the qualifications for the Kirkeminde scholarship

 

____________________________________________________                              _________________

Student Name                                                              Date

 

** Attach the following additional documentation:

- copies of official transcript/s from high school or college