Mar 29, 2017 - Harvard Woman's Club Scholarship. 2017 Application Form. Harvard Woman's Club - PO Box 438, Harvard, Mass
Harvard Woman’s Club Scholarship
2017 Application Form 1. Name (Last, First, Middle): ________________________________________________________ 2. Home Address (Street, Town, State, ZIP): ______________________________________________ 3. Phone: ____________________ E-Mail address: _________________________________ 4. Date of Birth (Month, Day, Year): _______________________ 5. School Extra-Curricular Activities and Sports: Activity
Position/Office
9
10
11
12
(List additional activities and sports on page 4)
6. List of All Honors, Awards Received in past four years Honor, Award
Indicate type:
(Scholastic, Sports, Extra-Curricular, Civic, Work)
(List additional honors and awards on page 4)
Harvard Woman’s Club - PO Box 438, Harvard, Massachusetts 01451-0438 harvardwomansclub.wordpress.com/contact-us
Year
Applicant Name: ________________________________________ 7. List all Activities:
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(Church, Scouting, Civic organizations, employment)
Activity
Position
9
10
11
12
(List additional activities on page 4)
8. Name of Accepting College/University: __________________________________________ THIS SECTION TO BE COMPLETED BY YOUR HIGH SCHOOL School Name: ___________________________________________________________________________ School Street Address: ___________________________________________________________________ City: State: Zip Code:_______________________________________________________________ GPA on a scale of: ___________________ Graduation Date: ___________________________ Guidance Counselor’s Signature: _____________________________________________________ Printed Guidance Counselor Name: ___________________________________________________ Guidance Counselor Office Telephone Number: __________________________________________ Guidance Counselor E-Mail: __________________________________________________________
I hereby certify that the information provided in this application is accurate. ______________________________________________ _________________ Signature of applicant Date ______________________________________________ _________________ Signature of parent or guardian Date (If applicant is under age of 18)
Harvard Woman’s Club - PO Box 438, Harvard, Massachusetts 01451-0438 harvardwomansclub.wordpress.com/contact-us
Applicant Name: ________________________________________
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REMINDER: Please attach the following required documents: 1. Letter of Recommendation (from Principal, Guidance Counselor, Coach or Teacher)
2. One essay – you may use one submitted with college application 3. Short biography of applicant, including career goals
Harvard Woman’s Club - PO Box 438, Harvard, Massachusetts 01451-0438 harvardwomansclub.wordpress.com/contact-us
Applicant Name: ________________________________________
Harvard Woman’s Club - PO Box 438, Harvard, Massachusetts 01451-0438 harvardwomansclub.wordpress.com/contact-us
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