Blue Ridge Lions Club

PO Box 146

Blue Ridge Summit, PA 17214

717 794-2809

2008

APPLICATION FOR STUDENT AID SCHOLARSHIP

All Information Contained Herein Is Strictly Confidential

Directions for submitting application:

1. The following credentials must be mail to Blue Ridge Lions

A. Official copy of High school or College transcript

B. Photograph (senior year picture)

If you would rather print application and mail or Fax 717 794-0105

2. Deadline for submitting this application is April 1. The above credentials should be returned to:   Chairman of the Scholarship Committee, Blue Ridge Lions Club, P. O. Box 146, Blue Ridge Summit, PA 17214.

Students Name: Last First Middle        

Address: 

City     State     Zip    Phone 

E-Mail 

Place of Birth    Date of Birth 

High School or College Name       GPA    

Date of Graduation       Rank in Class 

College you plan to attend: 

Date of Acceptance 

College Major      Estimated Total Cost Per Year 

List other sources of financial aid for which you applied:

Extra-Curricular/Out of School Activities

Activities In and Out of School  

Family Data

Fathers Name Occupation      

Address     

Employer    

Mothers Name Occupation      

Address      

Employer      

Please explain any special family circumstances that the Committee should be aware of.  

Students Justification For Scholarship Consideration

(Please indicate why you are applying for this scholarship.)  

Note you may get an Error when submitting but the email will go though. E-Mail Question