ARCHIVAL PAGE
Extended deadline for complete scholarship forms: January 15, 1998
Name: _______________________________
Address: _____________________________________
_____________________________________________
Phone: ____________________________________
email: _______________________________________
Breakdown: We are asking for a breakdown of your actual or estimated costs for travel, hotel, food, registration, misc.; how much you will be able to contribute; how much you will be able to raise; and how much you are requesting from us at a maximum being the registration cost.
Financial need: Travel: _________ Hotel: _________ Food: _________ Misc.: _________ Registration: ___ Total: _________ Minus your personal contribution: _______ Minus how much you can raise: _________ Your request from us (up to $40): ______
Financial need:
Travel: _________
Hotel: _________
Food: _________
Misc.: _________
Registration: ___
Total: _________
Minus your personal contribution: _______
Minus how much you can raise: _________
Your request from us (up to $40): ______
Demographic Questions:
Some of our funding organizations request that we provide them with demographic data about our scholarship recipients. We would appreciate it you would answer these few brief questions about your background. These questions are optional.
race/ethnicity age: please select one Essay Questions: