Return to library by Friday, April 18, 2014

Gallatin High School

Family Heritage and Alexander Funeral Home Scholarship

Two $1,000 scholarships awarded, one from each funeral home, two different GHS
students awarded. 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 why you wish to enter your chosen field.
Indicate how your education at Gallatin High School has enabled you to achieve your
high academic record. Also, briefly state why you should be chosen for this scholarship.
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