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Return to library by Friday, April 18, 2014

Gallatin High School

Dan P. Herron Scholarship


$1,000 awarded on the basis of application and essay.
Students Name:________________________________________________________
Address:_______________________________________________________________
Parents Names:________________________________________________________
Fathers place of employment:______________________________________________
Mothers place of employment:_____________________________________________
College you plan to attend:________________________Major:___________________
Number of children supported by parents_____________________________________
Number of children in college (include yourself):________________________________
ACT Composite:__________Grade Point Average:___________
What school or class offices are you now holding? What clubs are you a member?
What school sports do you participate in?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Essay: On a separate typed page state briefly, in 500 words or less, why you are
deserving and should be awarded this scholarship. Include in the essay your financial
needs and aspirations after high school.
I hereby acknowledge that the information submitted herein is true and accurate.

________________________________________________________________________
Signature of Applicant

Date

________________________________________________________________________
Signature of Parent/Guardian

Date

________________________________________________________________________
Signature of School Official

Date

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