Prince Hall Masonic Foundation, Inc, 600 WEST WALNUT STREET, SUITE 30 MILWAUKEE, WI 53212 www.princehallfoundationwi.com 2016 2017 SCHOLARSHIP APPLICATION FORM Helping Dreams Come True Last Name, First Name, Middle Initial Social Security Number Birth Date Home Street Address City, State, Zip Home E-mail Address Home/Cell Phone (Area Code) US Citizen or Permanent Resident? Native American/Alaskan Black Hmong Male Asian/Pacific Islander Hispanic White Yes No Female 1) Name of Parent(s) or Guardians City, State, Zip Occupation Place of Employment 2) Name of Parent(s) or Guardians City, State, Zip Occupation Place of Employment Total Family Yearly Income Name of High School Attending Cumulative High School Expected Date of GPA Graduation School Street Address City, State, Zip School Phone (Area Code) School extra-curricular activities: Awards and honors: Date Date What college or university do you plan to attend? Financial Aid? Yes or No How much will it cost you and your family to attend the college of What Resources your choice for one year? Special Circumstances: State any needs that you or your family feels are unusual and that you would like for us to consider: 1
Prince Hall Masonic Foundation, Inc, 600 WEST WALNUT STREET, SUITE 30 MILWAUKEE, WI 53212 www.princehallfoundationwi.com Write a brief description of yourself: Career or Job Related Information How Many Hours Per Week? Place of Employment Do you work part time? Community Involvement: Letters of Reference Community Church: School: Employment: I do hereby certify that the above information is true and correct to the best of my knowledge. APPLICANT'S SIGNATURE DATE *You must be present at the awards banquet Sunday, April 23, 2017 to qualify for the award. This application along with the counselor s section, high school transcripts, and three letters of reference must be post marked by Friday, March 31, 2017. Please mail application to: Prince Hall Masonic Foundation, Inc. c/o Scholarship Committee 600 West Walnut Street, Suite 30 Milwaukee, WI 53212 2
ESSAY PAGE #1 Directions: On the sheets provide or on a separate sheet of paper write an essay (must be word processed) consisting of, no more than 250 words telling your future education and career goals. Student's Name: Student's School 3
ESSAY PAGE #2 Directions: On the sheets provide or on a separate sheet of paper write an essay (must be word processed) consisting of, no more than 250 words: What does Prince Hall Masonry mean to you? 4
Prince Hall Masonic Foundation Scholarship Application COUNSELOR'S SECTION Student Name (Last Name, First Name, Middle Initial) Cumulative High School GPA Name of High School Attending Student's Class Rank in a class of seniors Comments: NOTE: Please attach a copy of the student's high school transcript. Print Name: Signature: Title: Date: 5
CRITERIA FOR EVALUATION 1. Purpose To encourage young people of our communities to continue their education so that they may become better educated citizens and give them financial assistance to do so. 2, Eligibility High School Seniors who have special financial needs and are seeking educational assistance to either a fouryear college, two-year college, university, vocational school, trade school, or business school. Student must have a cumulative grade point average of at least a 2.0 on a 4.0 grading scale. 3. Application A completed application, three letters of reference, and a copy of the high school transcript must be post marked by Friday, March 31, 2017 The application form and supporting materials should be mailed directly to: 4. Criteria Prince Hall Masonic Foundation, Inc. c/o Scholarship Committee 600 W. Walnut Street, Suite 30 Milwaukee, WI 53212 We are asking your assistance in this effort by recommending students to us who you feel are qualified and sincere about continuing their education. This year our emphasis will be on both young males and females who strongly desire to graduate from a post high school institution maintaining a 2.0 grade point average in high school. 6