College Application


Alworth Memorial Fund Home Page
Application for College Students DEADLINE: January 15, 2008
Note: In October 2007, the Alworth Memorial Fund Board of Directors changed the policy and will only review applications from graduating seniors. However, students who applied in 2007/2008 and have a current college GPA of 3.3 or higher may apply to receive a scholarship in 2008/09.
Use the Tab Key to navigate to a new field. If you accidentally hit enter, click on the "back" arrow in the upper left hand corner to retrieve your work. When entering the How Many More Years, enter a number only. For example, type in the number 4, do not type the word four. Employment "hours per week", enter a number only. No+ signs such as in 8+ hours. For example, type in the number 40, do not type the word forty. Your Age Last Birthday. Enter your age only. Enter 18, not eighteen. When entering your expenses, enter round numbers only. Do not use commas, periods, symbols or dollar signs. For example, type 1250, not $1,250.25. Should you get the error page after submitting your application, click on the "back" arrow in the upper left hand corner to retrieve your work. You will get an email confirmation from our office informing you that we have received your application. If you do not get the email confirmation, you will need to submit another application.
Last Name:		First Name:
Middle Initial:		Male Female
Address:		Phone #:
City, State, Zip:
E-mail:
County	*You must have graduated from a high school in one of these counties to be eligible.
High School
Graduation Date:
Which college or University do you plan to attend next year?
City, State:
Your current Major Field of Study:
How many more years of college/graduate school do you expect to attend?
Have you applied for the Alworth Scholarship before? Yes No
Date of Birth:
Age as of last Birthday: Place of Birth:
Father's Name:		Father's Age:	Deceased
Father's Occupation:
Father's Home Address:		Business Phone:
Mother's Name:		Mother's Age:	Deceased
Mother's Occupation:
Mother's Home Address:		Business Phone:
Please list the names and ages of your brothers and sisters. If any of your siblings are now attending college, please indicate the name of the college.

If you have had employment, please list:
Employer	Type	Dates	Hours Per Week





Please list any form of financial aid (scholarships, grants, aids, work/study, etc.) that you are presently receiving or expect to receive. Presently Receiving: Expect to Receive: The table below outlines a budget of your next year at school. Complete it carefully with the help of a parent, guardian, or counselor. If you plan to live at home, omit completely the item of room and board either as an expense or contribution of parent or guardian.

EXPENSES		RESOURCES
Tuition and fees:	$	From savings or investments:	$
Room and board:	$	From parents or estate:	$
Transportation:	$	From part-time work:	$
Books and supplies:	$	From tuition grants/incentives:	$
Incidentals (recreation, laundry, etc):	$	From other scholarships:	$
Clothing:	$	From loans:	$
		From other sources:	$
Total Expenses:	$	Total Resources:	$
		Needed to balance budget:	$

List the high school extra curricular activities that were most important to you:

Add additional information about your activities in college and the community:

List the honors, prizes, offices held, or special recognitions received in high school and/or college. Please respond freely and completely.

High School Honors:

College Honors:

Obtain a letter of recommendation from one of your college professors. Provide professors name and field of study below.

List the date you requested your high school counselor to send a copy of your high school cumulative record to the Alworth Scholarship office:

List the date you requested your college registrar to send a copy of your current transcript to the Alworth Scholarship office:

What was the size of your high school graduating class?
What was your rank in the class?
What was your grade point average in high school?
What is your current grade point average in college?

Financial Information:

Since Alworth Scholarships are awarded to persons who have a financial need, the decision of the Board of Directors is based in part on information about a family's financial situation. Please respond to the questions below, remembering that responses will be held in strict confidence.

Are you dependent on your parents for their financial support of your college studies? Yes No

Regarding the verification of financial need, dependent applicants for the Alworth Scholarship must mail a copy of your family's financial IRS tax form 1040, pages 1 and 2, for the year prior to this application date. Independent students must mail a copy of their own IRS Form 1040, pages 1 and 2.

If your parents do not file with the IRS, please explain.

Please Note: Applications will be considered by the board of Directors only if the requested financial need information is included in the application. The IRS Form 1040, pages 1 and 2, for the current year, or for the year prior to this application may be sent after the January 15, 2008 deadline but before March 15, 2008.

Briefly tell us: Why do you think that you should be selected for this scholarship?

If you would like to print a copy of your completed application for your records, click the Print Completed Application button. Then click the print button on the toolbar of the window that opens.

All the information submitted on this form constitutes my application for the Marshall H. and Nellie Alworth Scholarship and is correct and true to the best of my knowledge and belief. I understand that all information furnished to the board of Directors shall be kept confidential.

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