KarMel Scholarship Application 2010
PERSONAL INFORMATION
KarMel Scholarship Application 2010
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First Name:
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Last Name:
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Home
Address: |
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City: |
State: |
Zip: |
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Phone:
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Email:
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Gender:
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Birth
Date: |
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EDUCATIONAL INFORMATION
Current Status:
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High School Student |
College Student |
Planning to Go Back to School |
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School Currently Attending (if applicable): |
SCHOLARSHIP DETAILS
· You can
submit 1, 2 or 3 submissions in the “Written” category.
· You can
submit 1, 2 or 3 submissions in the “Artistic” category.
· You can submit
a maximum of 6 submissions.
· You can
submit to either or both categories.
· Do not
put your written submission into the application. Attach it as a separate file or document.
WRITTEN
CATEGORY
Title of Submission Description
of Submission (be as detailed as possible)
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1) |
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2) |
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ARTISTIC
CATEGORY
Title of Submission Description
of Submission (be as detailed as possible)
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1) |
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2) |
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3) |
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MISC INFORMATION
Check
the box, if you DO NOT want your name posted next to your submission on the
website.
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How did you hear about the scholarship? (Check
all that apply.)
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Scholarship Search Website |
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GSA/PFLAG |
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Other _____________ |
CERTIFICATION
My
signature below attests:
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To the accuracy of the information supplied above.
2. That the material submitted is my sole and original work.
3.
That the Karmel Scholarship may retain and publish my
submission for the KarMel Scholarship website
only.
4. All candidates agree to indemnify KarMel Scholarship entirely of any Copyright, Trademark, or other infringement if the situation arises.
5.
To my understanding of the purposes, rules, guidelines
and conditions of the KarMel Scholarship and to my
acceptance of them.
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Signature of Applicant *
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Date *
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