Camden Alumni Association Scholarship Application Form
Please print clearly, or type, all information requested on the form below
Student’s
Name:_____________________________________ Phone Number:___________________
Address:_____________________________________________________________________________
High
School Average:________ Rank in Class: ______________
Please complete ALL information
below and return the form
to the Guidance Office no later than Friday May 2, 2009.
In order to qualify for this scholarship you
must have been accepted at an accredited two or four year institution of higher learning for the Fall, and have a mother, father,
step parent or legal guardian who has graduated from Camden High School or Camden Central School.
Complete the following information
as it applies to you for your parent, step parent, or legal guardian who qualifies you for this scholarship.
Name:____________________________________________________________
Maiden
Name, if Mother: _____________________________________________
Year of graduation from Camden High School or Camden Central School
of
the qualifying person:___________________
Number of dependent children in your family’s household:_______
Number of dependent
children, including yourself, who will be attending college in the Fall:________
1. Have you taken part in any
Community Activities?
Specify:___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2. In what extra-curricular activities
have you participated? (e.g. sports, clubs, music, drama, etc.)
Specify:___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. What has been your work experience?
Specify:__________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
4. Are there any extenuating circumstances
that have prevented you from participating in any
of the above?
Specify:__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
To which institution of higher learning have you been
accepted?
_________________________________________________________________________
Continue
the application on the reverse side of this form.
Answer the following question in 100 words or less: What are your goals and/or
your expectations for your future?
Attach a copy of your college acceptance letter to this form.
The information on this form
is, to the best of my knowledge, truthful and accurate.
Signed:_______________________________________________________ Date:________________
Revised:
10/2005