Scholarship Application

The following MUST be attached to this application:

1. Official High School transcript issued by the school (including test scores such as SAT, ACT, etc.) If you are now enrolled as an undergraduate or graduate student, an official transcript of your college record through the most recently completed semester, quarter, or similar term.

2. A list of prior school activities, awards, offices held, and honors (high school and/or college).

3. A list of all community and volunteer activities within the community.

4. A short list of any extenuating circumstances you may have.

Application Deadline: April 15, 2022

1. The issuance of any scholarship is conditional on enrollment as a full-time student (taking at least 12 credit hours, per semester or term leading to a degree.) at an accredited college, university or community college located in the United States.

2. Selection of scholarship recipients will be based on scholastic performance and aptitude.

3. Applicant must be a graduate of a public high school, private high school, or student of the Accredited Home School Program (with a G.P.A. of 3.0) or currently enrolled as an undergraduate or graduate student at a college, university or community college maintaining a G.P.A. of 3.0.

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

County *

Number of Years at this Address *

Phone Number *

Email *

Date of Birth *

Father's Name *

First

Last

Father's Address *

Line 1

Line 2

City

State

Zip Code

Country

Mother's Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Applicant's (Student) Employer (if employed) *

Number of Years Employed *

Position *

Educational Information

Name of High School *

High School Address *

Line 1

Line 2

City

State

Zip Code

Country

Name of High School Counselor/Advisor *

First

Last

Counselor/Advisor Email *

Counselor/Advisor Phone Number *

Month & Year of High School Graduation *

Grade Point Average *

Number of Earned of college credit at High School graduation (AP or Dual Enrollment credits) *

NOTE: A copy of your High School transcript (including test scores such as ACT, SAT, etc.
if required by the school to which you are applying or enrolled) must accompany this
application.

Upload File *

Max file size: 20MB

Upload File *

Max file size: 20MB

Upload File *

Max file size: 20MB

List of prior school activities, awards, offices held, and honors (High School and/or College *

Max file size: 20MB

List of all community and volunteer activities *

Max file size: 20MB

Name of school you will attend *

School Address *

Line 1

Line 2

City

State

Zip Code

Country

Financial Aid Office Phone Number *

Your Anticipated Declared Major *

Extenuating Circumstances you would like us to consider *

Do you qualify for a Pell Grant? *

Do you have a Masonic relative? (answering no does not disqualify you) *

If yes, give name and relationship *

Please sign below that the application is true and correct.

Name *

First

Last

Date Submitted *

Include one letter of recommendation *

Max file size: 20MB

Submit