MONTANA CLERK & RECORDER'S. SCHOLARSHIP APPLICATION FORM AMOUNT OF SCHOLARSHIP $1,000.00 First Place Winner $500.00 Second Place APPLICANT MUST BE A GRADUATING SENIOR WHO WILL BE ATTENDING AN IN STATE SCHOOL. This Application for the Clerk & Recorder's Scholarship becomes complete and valid only when you have returned the following material: [hr rplication [7A tt required signatures [current Transcript of Grades [_]Application deadline: March 16, 2018 Return completed application to: Debbie Pierson Flathead County Clerk & Recorder 800 South Main, Rm 114 Kalispell, MT 59901 Or deliver in person to the Clerk & Recorder's Office located in the Historic Flathead County Courthouse Updated 12/19/2016“APPLICANT INFORMATION, County Mr. Ms, (ast) Fist ‘ie Tia Telephone Number Permanent Adaress (street) 0) (ate) cy Father's Full Name Occupation Permanent malig adress of paren artaniteiterent om open Taree) Tey) (state) Cp) Mothers Full Name Occupation Permanent mating adress of guardian citernt om applant (realy Tey) (alate) ip) Total number of family members who wal be attending a post-secondary ‘school atleast 1/2 time during the upcoming school year, including applicant. High Schoo! Attended Graduation Date (Wont) __(Yeary Address. (realy Tau) Tstatey ze) ‘Telephone Number Nam of post-secondary school for which appcants scholarship is equestd 4yrcategatunie [vote ‘Community Cotege|__Jomer nccosecrves [To Address ) (state) PY Major field of study applicant plans to pursue ‘Applicants Signature Date Completed Thave read this application, ates to te accuracy thereof to the best of my knowledge, understand that te candidate is applying for a Montana Clerk & Recorders scholarship, and have no objection theret. Parent or Legal Guardian's Signature Date Completed Day Year TRANSCRIPT INFORMATION High school seniors must include a high school transcript of grades and have the {ollowing section completed by the appropriate school official. Clase/Rank: ina class of ‘Cumulative grade point average \4.0 scale. ‘School Offiars Signature Date Telephone # Updated 04/29/2011Please ist our work experiance during the past 4 years. Indicate dates of employment in ‘each job and the approximate number of hours worked each week. List total amount earned for leach job. POSITION. Date | Date on Hours Per Week [This Postion Pasa desc how rd when any unusual fay operon raunsaces ave acted yor ace yur partlpaion in school and community activites. in merite fami vores, Vagedy, adverse franca creumstances, et) (Fnaceseary,atiachadllcoal pages.) Updated 04/20/2011