|
KSBCF WILL EVANS SCHOLARSHIP APPLICATION
To be eligible for consideration, the applicant must meet Kentucky Office for the Blind criteria for educational or vocational services.
- Application Deadline: Applications are due April 1 of each year.
- Applicant must currently be a Kentucky resident.
- Recommendations are required from school personnel or from the Kentucky Office for the Blind personnel (additional recommendations may be submitted from non-school personnel).
Name: _______________________________________ Birth Date:
_____ / _____ / _____
Address: __________________________________________County: _________________
City:
___________________________________ State: _________ Zip: ______________
Phone:
(home) ________________(work) ________________
(cell) ________________
E-mail: ____________________________________________________________________
School/program
(currently attending): __________________________________________
Anticipated
date of completion (please include transcripts): ___________________
School/program
you will be attending next year (post secondary):
_________________________________________________________________________
Have
you been accepted by the above school/program? YES _____
NO _____
Course
of study (goals):____________________________________________________
Are you currently enrolled in a post-secondary program? YES _____ NO _____
If YES, name the school/program: __________________________________________
Course of study (goals): ___________________________________________________
Have
you applied for or received other financial assistance?
YES _____ NO _____
If
YES, from whom? ______________________________________________________
Please list your special
achievements, activities, volunteerism, and awards:
______________________________________________________________
______________________________________________________________________
_______________________________________________________________________
Briefly
state how this scholarship will apply to your educational
endeavors (goals):
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
I state that I answered the above information accurately and to the best of my ability.
Signature
of Applicant: _______________________________ Date:
______________
Please submit
this application to:
Kentucky
School for the Blind Charitable Foundation, Inc.
Attn: Will
Evans Scholarship Committee
214
Haldeman Avenue
Louisville,
Kentucky 40206
Fax: (502) 897-3194 | E-mail: contactus@ksbcf.org | Phone: (502) 897-3990
OFFICE USE ONLY
Date Application Received: ______________ Board Action: _____________________
Remarks: _____________________________________________________________
|