Richard H. Crosser Memorial Scholarship Application

A Senior at LC or LN

In the top 1/3 of your class

Majoring in a field related to building trades

Attending a two or four year Indiana college or university

Involved in a variety of activities

 

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Richard H. Crosser Memorial Scholarship Fund

Application________________________________________________________________

Social Security Number: ____-____-____  Name: ___________________________________

Permanent Indiana Address: ___________________________________________________

_________________________________________________________________________
City                                                                 State                       Zip Code

Phone Number: ________________________ E-Mail: ______________________________

Parent(s)/Guardian(s) Names __________________________________________________

High School Attended: _______________________________________________________
                                         Name                                       City                                    State

Current Cumulative GPA: _______ (4.0 scale)  Anticipated Graduation Date: ______/_____

Educational Institution you plan to attend:

1) _______________________________________________________________________
                     Institution Name                                                                  Phone Number

_________________________________________________________________________
                     Address                                            City                            State            Zip Code

2) _______________________________________________________________________
                     Institution Name                                                                  Phone Number

_________________________________________________________________________
                     Address                                            City                            State            Zip Code

Have you been accepted at your first choice college or university?   Yes _______     No ______
If no, when do you expect to be notified? __________________________________________

Have you been accepted at your second choice college or university?   Yes _____    No ______
If no, when do you expect to be notified? __________________________________________

Intended Major Course of Study: ____________________ College Graduation Date ____/____

Where do you plan to live next year? On Campus _____    Off Campus _____   
With Parent(s) _________ Other_______________________________________________

Work Experience, Awards, Recognition and Activities
On a separate sheet, please list places of employment over the last four years, approximate hours worked weekly, and total amount earned.  In a separate section, please list all school and community activities and honors over the last four years.

Goals and Aspirations
On a separate sheet, describe in fifty words or less your personal and educational goals including your current thoughts about your career and future.

Checklist  
This application for a scholarship becomes complete and valid only when completed in its entirety with all required attachments.

[  ]   Student Application
[  ]   List of work experience, awards, recognition and activities
[  ]   Description of goals and aspirations
[  ]   Transcript of Grades

The application and 9 copies must be submitted to the Lawrence Township School Foundation on or before Thursday, March 27, 2008.

In submitting this application I certify that the information provided is complete and accurate to the best of my knowledge.  Falsification of information may result in termination of any scholarship granted.

Applicant's Signature _____________________________________  Date _____________