Rosemarie Maher Academic Scholarship

Applicant Information

First Name:

Middle Initial:

Last Name:

Mailing Address:

City:

State:

Zip Code:

Cell Number:

Education Information

School Attending:

Financial Aid Office Mailing Address:

City:

State:

Zip Code:

Type of Institution:CollegeVocationalOther:

Expected Graduation Date:

Cumulative GPA:

Type of Degree:

Field of Study:

Enrollment Status for Upcoming Term:Full TimePart Time

Checklist of Required Documents

Transcript from last school attended

Proof of enrollment

Letter of recommendation

Personal essay

Student Certification

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any false statements may disqualify me from receiving this scholarship.

Signature

Date