RALPH D. EHRET MEMORIAL SCHOLARSHIP

SCHOLARSHIP APPLICATION

GRADUATING SENIOR FORM

All items must be completed.  Please type your responses.

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 _________________________________________________

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?

5.  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/VO-TECH?

6. 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