RENE MATOS MEMORIAL SCHOLARSHIP APPLICATION

(Deadline:Postmarked by May 1) (Please type or print all information.) Personal Data:
Social Security Number: 1. Please select one. Mr. Mrs. Miss Ms.

Name
(Last) (First) (Middle)

2. Applicant's Marital Status (Optional): 3. Mailing Address: (While school in session) Number and Street: City: Phone Number:

Single

Married

Single Parent

State:

Zip Code:

Mailing Address: (During summer/semester break) Number and Street: City: Phone Number: 4. Father's Name: Number and Street: City: Phone Number: 5. Mother's Name: Number and Street: City: Phone Number: Are your parents members of NHCFAE?
Yes No

State: email:

Zip Code:

Occupation:

State:

Zip Code:

Occupation:

State:

Zip Code:

IMPORTANT: Information requested for the following items must be provided in the space provided or on a separate sheet. However, the information must be in the same sequence and same headings as requested. Information referred to in resumes or other documents will not be considered if not in the format and sequence requested.

. Spanish Club. Dean's List. Treasurer.) D) Leadership Role(s): (Club President.e. Secretary. School Newspaper. Secretary. etc.. Scholarships/Honors: A) Scholarship awarded: (i. etc. etc. etc. etc. Kodak Award. Treasurer. Band. etc.) B) Honors awarded: (i.e..e.) B) Leadership Role(s): (Club President. Who's Who.e.) 7. Participation in organizations outside of school: Community activities: (i.) .e.) 8.. National Honor Society. Science Club. etc. Service Club. Feeding Homeless. National Young Leaders Conference. Big Brother/Sister.6.. Mentor. Participation in student organizations while in school: A) Organizations/activities in conjunction with coursework: (i.) C) School clubs/activities outside coursework: (i.

) Certification: All of the information on this form is true and complete to the best of my knowledge.) Office of Student Financial Services or Financial Aid Office Address: Number and Street: City: Phone No. Student's Signature Date . Name of school to be enrolled: (NOTE: Checks will only be issued in the name of the student and of the school. Select One: High School Senior Community College/Vocational/Trade (1st/2nd yr) University (1st year/2nd year/3rd year/4th year) Graduate (Month and Year of Graduation) State: Zip Code: Number of Credits: Number of Credits: Number of Credits: 12. I hereby give NHCFAE permission to use my name for the purpose of public relations.e. Major field of study: Number of Credits Completed: Family Financial Data: Since the NHCFAE Selection Committee will consider the family financial situation as an important element in determining award.Academic Data: 9. Incomplete or late applications will not be accepted. i. Financial information will be used to determine financial need and verified from the financial reports submitted to school.0): High School: Vocational or Trade School: Undergraduate: 11. of Financial Services/Aid Office of school to be enrolled: 10. and/or FAFSA. (Parent's estimated combined earnings will be used for single students under 23 years of age. Present grade point average (Based on 4. SAR..

Sign up to vote on this title
UsefulNot useful