Scholarship you are applying for: ____________________________________________

Name (Last, First, M.I.)____________________________________________________

GHC Student Number Number ____________________________________________________

Address (Street, City, State, Zip)_____________________________________________

Date __________________

Telephone_______________________ email_______________ GPA________________

High School Graduation Date_____________ Name of High School ________________

Clubs/Organizations/Activities (please specify positions and dates):

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Leadership Positions Held (please specify position and dates):

________________________________________________________________________

_________________________________________________________________________

Special Skills/Talents:

________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

 

Work Experience (position and dates held):

__________________________________________________________________________

_________________________________________________________________________

__________________________________________________________________________

Community and Volunteer Service:

___________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Tell us why you should be considered for a this scholarship (you may attach a separate sheet):

__________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Please accompany this application with one letter of recommendation from someone (must be a non-relative) who can attest to your academic ability and leadership potential.