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Monroe Lions Club Scholarship

Awarded to ONE BOY ~ ONE GIRL MALE _____ FEMALE_____

Name: ________________________________________________________________
Parent’s Name(s): ______________________________________________________
Father’s Occupation: ____________________________________________________
Mother’s Occupation: ___________________________________________________
How many children in your family?___________ Phone #____________________
How many children presently in college or vocational school?___________________
What are your career plans?______________________________________________
_______________________________________________________________________
Where will you attend school? _____________________________________________
Have you been accepted? _______________ Course of Study: _________________
How do you plan to finance your education?_________________________________
List extracurricular activities: ____________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Remarks (Reason for applying, why you choose your intended major and any other
information that you feel may be of interest to the scholarship committee: ________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
OFFICE USE ONLY
RANK: ___________ GPA: _____________

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