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FLORENCE WENDORF MEMORIAL SCHOLARSHIP
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CANDIDATE INFORMATION
NAME (Last, First, Middle Initial)
___________________________________________________________________
ADDRESS (Street, City, State, Zip)
___________________________________________________________________
PHONE (______)_________________
AGE _________ SEX ________
DATE of BIRTH _____/_____/_____
PLACE of BIRTH (City and State)_______________________
SCHOOLS ATTENDED:
Name of School ____________________________________________
Date of Entrance ____________________________________________
Period Attended ____________________________________________
Name of School ____________________________________________
Date of Entrance ____________________________________________
Period Attended ____________________________________________
Briefly describe your affiliation with Grace United Methodist Church:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Please list any past and/or current extra-curricular activities, community involvement, etc.:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Write a brief statement indicating why this scholarship is financially important to you:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
(The back side of this application may be used for additional information.
All of this information may be typed on a separate sheet.)
PARENTAL INFORMATION
Father's Name _______________________________ Occupation______________________________
Mother's Name _______________________________ Occupation______________________________
Please return by March 31st to:
Scholarship Committee, Grace United Methodist Church
302 So. 9th St
Livingston, MT 59047
graceumc@ycsi.net