EULALIE W. PARKER AND TED G. PARKER MEMORIAL SCHOLARSHIP

SCHOLARSHIP APPLICATION

GRADUATING SENIOR FORM

All items must be completed.  Please type your responses.  All applicants must be graduating seniors from Carter County High School.

NAME:

ADDRESS:

DATE OF BIRTH:

PLANS FOR FINANCIAL SUPPORT IN FURTHERING EDUCATION (Check all that apply):

_____ Total self-support

_____ Part-time work will be necessary

_____ Partially supported by family

_____ Scholarship (identify) _________________________________________

FATHER'S NAME ________________________________ IS HE LIVING? ______

FATHER'S OCCUPATION _____________________________________________

MOTHER'S NAME _______________________________ IS SHE LIVING? ______

MOTHER'S OCCUPATION _____________________________________________

NUMBER OF BROTHERS AND SISTERS AND AGES _______________________

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CLASS RANKING ________ OF _______

GRADE POINT AVERAGE ____________

PLEASE ATTACH ADDITIONAL SHEETS AS NEEDED TO RESPOND TO THE FOLLOWING:

1.  WHAT ACTIVITIES HAVE YOU PARTICIPATED IN WHILE IN HIGH          SCHOOL?

2.  WHAT OFFICES HAVE YOU HELD IN HIGH SCHOOL?

3.  WHAT HONORS, AWARDS OR PRIZES HAVE YOU RECEIVED?

4.  IN WHAT OUT-OF-SCHOOL ACTIVITIES HAVE YOU PARTICIPATED?

(CONTINUED ON REVERSE)

5.  WHAT COURSES DID YOU LIKE THE BEST AND LEAST IN HIGH SCHOOL        AND WHY?

6.  WHAT WORK EXPERIENCE HAVE YOU HAD?

7.  WHAT INSTITUTION OF HIGHER LEARNING DO YOU PLAN TO ATTEND;         WHAT COURSE OF STUDY DO YOU PLAN TO UNDERTAKE; WHAT            TYPE OF DEGREE DO YOU EXPECT TO EARN; WHAT ARE YOUR    CAREER PLANS AFTER COLLEGE/V0-TECH?

8.  PLEASE WRITE 75-100 WORDS ON YOUR THOUGHTS AND ATTITUDES              REGARDING COLLEGE OR VO-TECH TRAINING.

9.  PLEASE LIST AN APPROXIMATE AMOUNT REQUIRED FOR THE FOLLOWING FOR ONE YEAR:

TUITION:

ROOM AND BOARD:

BOOKS:

All information is complete and accurate as provided.

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SIGNATURE OF APPLICANT                                                       DATE

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SIGNATURE OF PARENT OR LEGAL GUARDIAN                     DATE