Douglas Anderson High School No. 107 Alumni Association Inc.

Harold O “Buster” Hair Scholarship for Education - 2024

SCHOLARSHIP APPLICATION
Date:______________________________________

Personal Data
Name: __________________________________ _________________________ ____________________________

Date of Birth: _____________________________ Phone Numbers: ______________________ ________________

Home Cell
Current Residence: ________________________________ _______________________________ _________________
Street City Zip

Name(s) of Parent(s) or Guardian: ______________________________________________________________________

Number of Siblings who reside in household ____________ Brothers _______________ Sisters ___________________

Education Data
School presently attending:
__________________________________________________________________________________________________

School Address: ______________________________ _______________________ _________________ ____________

Street City State Zip

Grade Point Average (Grades 9 through first semester of senior year).

Transcripts must accompany the scholarship application.
_________________ _________________
Weighted Unweighted

SAT Scores: ______________________ _____________ ACT Composite Score: _____________

Verbal Math
Address: ________________________________________ _____________________ __________________ _________
Street City State Zip

College, University or Seminary you plan to attend: ________________________________________________________

__________________________________________________________________________________________________

Address: _____________________________________________ _____________________ ___________ __________

Street City State Zip

You must show proof of acceptance before scholarship is awarded

Recognitions and Awards
List any honors and recognition that you have received (grades 9-12)
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

Student Activity/Club and Organization Information/Community Service

Please complete each section. Do not be Modest! All information can be used by the
scholarship committee during the selection process. (attach additional sheets if needed)
Activity/Club/Organization Grades (9, 10, 11, 12) Leadership Position Held
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

Relative
Please give the name, year and your relationship to a relative that graduated from Douglas
Anderson High School No. 107 prior to 1969.
__________________________________________________________________________________________________
__________________________________________________________________________________________________

References
Three letters of references are required. One must come from a Teacher, one from a
Counselor and one from a church Member, a Neighbor, or an Employer. References from
relatives will not be considered. Letters of reference should address the following.

Character • Personality • Motivation • Initiative • Sense of responsibility • Citizenship

Educational Goals: Write a letter which clearly and completely details your future plans.
Letter must be included with the application.

Deadline for application and letters of references: May 1, 2024

Note: Applications received after the deadline will be disqualified.

Direct application and letters of reference to:

Douglas Anderson No. 107 Alumni Association, Inc.
Attention: Mrs. Constance M. House, Scholarship Chairman
Post Office Box 5583
Jacksonville, Florida 32247-5583
Updated
03/18/2024 fdc