Haywood High School Local Scholarship Application


Name of Scholarship


Your Name Your Address

City Zip Phone Number

Names of Parent(s)/Guardian(s)

Employer(s)

Number of other children dependent on parents/guardians

Total number in family

Age Gender Race Religion

Grade-Point Average in High School Rank in Class

Number in Graduating Class A.C.T. Score

Employment Experiences

Employer
Date
Type of Work

Extra-curricular activities, including scholastic and leadership honors - offices held, articipation in school, church, and community activities

 

Future plans - college you plan to attend, possible field of study, plans after graduation from college

List any other factors that will help the committee to evaluate you.