SCHOLARSHIP APPLICATION

ENTIRE APPLICATION MUST BE TYPED

Applicant’s Full Name: _________________________________________________

FOR THE ACADEMIC YEAR ________AT ___________________________(name and location of college/university)

INSTRUCTIONS TO APPLICANT: READ CAREFULLY.

1. Students applying for these scholarships must be graduating from one of the following public high schools: Bainbridge Island, Bremerton, Central Kitsap, Chimacum, Clallam Bay, Crescent, Forks, Klahowya, Neah Bay, North Kitsap, North Mason, Olympic, Port Angeles, Port Townsend, Quilcene, Sequim or South Kitsap

2. Include a 100-word goal statement, double-spaced. Include comments on your career goals and how you hope to serve the public sector or society in general.

3. Submit an official, sealed grade transcript with your completed application. Send all materials, including transcript or transcripts, to Bremerton Valley of the Scottish Rite, Scholarship Committee, PO Box 424, Bremerton, WA 98337-0104. Students must have a grade point average of 3.2 to qualify for consideration for a scholarship.

4. Letters of recommendation must be original (not a Photostatted copy). They must on letterhead or the writer identified with name, address and telephone number, be dated and addressed to: The Scottish Rite Scholarship Committee. Letters addressed To Whom It May Concern will not be accepted.

5. All forms, attachments and enclosures must be received by the Scholarship Committee by March 31^st . It is the responsibility of the student to submit all paperwork to the address listed below.

Bremerton Valley of the Scottish Rite of Freemasonry

Attn: Scholarship Committee

PO Box 424

Bremerton, WA 98337-0424.

6. Failure to furnish all required materials, transcripts indicating a G.P.A. of 3.2 or equivalent, a current SAT score, three letters of recommendation, and your goal statement DISQUALIFIES the applicant.

(The Scholarship Committee of the Bremerton Valley of the Scottish Rite of Freemasonry reserves the right to disqualify applicant from any scholarship consideration, and the award of every scholarship is in the sole discretion of the Scholarship Committee of the Bremerton Valley of the Scottish Rite of Freemasonry. If in the opinion of the Scholarship Committee, the applicant fails to complete the application; such application will be automatically disqualified for any scholarship consideration.)

7. If selected for a scholarship, I understand that I will be expected to attend a public recognition ceremony and that my name and photo may be used for publicity by the Scottish Rite. The scholarship MUST be used for the period awarded.

8. I understand that any false information furnished in or with this application, or failure to furnish all required items will disqualify me for any award. I declare that I am a United States Citizen and a bona fide resident of the State of Washington.

------------------------------------------------------------------------------------------------------------------------------------------------------------

Applicants Signature Applicant’s Social Security Number Date

1. Your name in full (last, first and middle), last name first:

____________________________________________________________________________

Permanent address: ____________________________________________________________

City:_________________________________ ZIP:___________________

a. Telephone:(Home)____________________________________________

(Cell)______________________________________________

b. E-mail: _____________________________________________________

2. Birthplace:

City State or Province Country

3. Age:___________Date of Birth:____________________________________

4. Name and address of parents, foster parents, or guardian (Circle One)

Father: Occupation:

Address:________________________________________________________________

Telephone Number: _______________________________________________________

E-mail address:___________________________________________________________

Mother: Occupation:

Address: Telephone Number: _______________________________________________

E-mail address:___________________________________________________________

5. Siblings & ages:

1. List high school awards that you have received. Include all honors and commendations (include JROTC awards).

Award	Reason for Award	Date

2. What is your Major?______________________What is your Minor?__________________________

a. Do you plan on entering the teaching profession?______________________________________

3. College/University you plan on attending:(LIST NO MORE THAN TWO)________________________

4. SAT SCORES V: M: Total:

ACT SCORES

FINANCE

1. How do you plan to pay for college?

1. Organizations of which you are, or have been, a member. (School Related)

Name of organization	Involvement	Year(s)

2. In addition to the above, in what social, athletic, political, community, church, youth group, Masonic youth group, or other activities did you engage during high school years.

Name of organization	Type of participation	Dates

3. List the names of six references who have intimate knowledge of your academic, personal, or professional background. Have three of them submit letters of recommendation directly to you to be included with your completed application. Only those letters addressed to The Scottish Rite Scholarship Committee will be accepted. Letters from academic references, employers, religious leaders, and Masonic friends or relatives are preferable. Each letter of reference should be from a different category.

Name	Address	Relationship (Professor, friend, etc.)

4. In making application for a scholarship to The Scottish Rite Scholarship Committee of the Bremerton Valley of the Scottish Rite of Freemasonry, I do swear/affirm that I will support the Constitution and laws of the United States of America, and will by precept and example promote respect for the flag and the institutions of the United States of America.

Signed______________________________________

(Applicant)

(STRICTLY Adhere to 100 WORDS OR LESS)

(BE CONSISE, BE SUCCINCT AND BE DIRECT.)

(Applicant’s Full Name)

Signature Date