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SELMER H T MYREBOE POST 245 POULSBO WA

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Application for the

American Legion Post 245 Vic Schiavone Memorial Scholarship

Poulsbo WA.

Full Name:_______________________________________________________________DOB:_________

Address:______________________________________________________________________________

City:_______________________________________State:_______________________Zip:___________

Phone:_______________________________EMAIL:__________________________________________

Spouse, Child/Grandchild of Veteran    :____________________________________________________

Veteran Branch of Service:________________________

Dates Veteran Served:______________________, Attach copy of DD214 or proof of current service

 

Education Years Completed:___________________________ Current GPA:_______________________

Community Service

Performed:___________________________________________________________________________

 

School

Clubs/Associations:_____________________________________________________________________

 

Other:

(Awards/4H/BoyScouts/FFA)_____________________________________________________________

 

Education Institution (post-Secondary) which enrolled

and/or accepted for enrollment:__________________________________________________________

                                                       *Applicant shall attach a copy of a letter of acceptance, or copies of unofficial transcripts as proof of enrollment with this application. If awarded, scholarship check will be made payable to the institution.

Address/Phone:_______________________________________________________________________

 

This application is for the school year beginning in ___________________________________________

                                                                               (month) / (Year)

 

       NOTE: Applications must be post marked between 1 Jan and 1 May of the School Year

 

 

 

___________________________________________                                     ___________________

Signature of Applicant                                                                                                                                                                                                                                                                               Date

 

Mail original signed and dated application and supporting documentation to:

American Legion Poulsbo Post 245

PO Box 678

Poulsbo WA 98370-0678