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ALLEGHENY LODGE #339 B.P.O.E.

SCHOLARSHIP APPLICATION

Applicant Information

TO BE COMPLETED BY APPLICANT Date

Name (Last, First, Middle) S.S. # xxx-xx-

Home Address City State Zip

Phone Number Age Gender

School Information

High School Attended

GPA Class Rank Number in Graduating Class Date of Graduation

SAT/ACT College Board Score (optional) Verbal Math

Have you been accepted by a college? Yes No

Name of College

Address of College City State Zip

Course of study anticipated

Parent Information

Parent Name Allegheny Lodge Membership No.

Parent Address City State Zip

Required Signatures

Applicant Signature Date

*Parent Signature Date

(Allegheny Lodge Member)

*The Elk Parent of this Applicant has been a member in good standing since April 1, 2023.

Lodge Secretary Signature Date ____________________________

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Activities, Honors and Achievements

List any academic honors and awards you received in High School.

List any offices or leadership positions you held (date, organization, position) in High School.

List other extracurricular activities in which you participated or awards you have won.

List any volunteer or community service you have performed.

Letters of Recommendation
Include one Letter of Recommendation from a High School teacher.
Include one Letter of Recommendation from a responsible community member. The author cannot be related to you.
Letters must be dated and signed by the author.
Applicant Essay
Please type your essay in 300 words or less to the following question.
How will your education help you achieve your career objectives and future goals?

Application Checklist – the following must accompany this application

 A recent photo (within the past six months).

 A transcript of your High School grades including SAT/ACT College Board scores (if available).
 A letter of acceptance from an accredited College or University
 Two letters of Recommendation (see above)
 Applicant Essay.

Assemble Application in a pocket folder and mail or deliver to:

Student Aid Committee

Allegheny Lodge #339 B.P.O.E.

P.O. Box 6904

Pittsburgh, PA 15212

ACCEPTANCE DEADLINE – JULY 31, 2024