SCHOLARSHIP APPLICATION
Please print neatly or type
See end of form for general information and instructions
Name___________________________________________________ Date_________________
Address_______________________________________________________________________
______________________________________________________________________________
Telephone No.________________________________________________ Sex______________
Provide additional personal information (on separate pages) related to hobbies, interests, activities, clubs, churches, community groups or service, etc.
High School___________________________________________________________________
Location: Town_____________________________________________ State_______________
Telephone No._______________________________________ Graduation Year_____________
Grade Point Average__________________________
Provide additional information (on separate pages) pertaining to school related honors, sports, activities, offices, clubs, etc. that you are involved in during high school.
College Name (if applicable)______________________________________________________
Address_______________________________________________________________________
______________________________________________________________________________
Major______________________________________________ Graduation Year_____________
Provide additional information (on separate pages) about your course of study and anticipated career path and about any other involvements while attending college.
If not presently attending college, provide a listing of the schools to which you have applied/been accepted, your anticipated course of study, and some understanding of your interests in pursuing that course.
(over)
SCHOLARSHIP APPLICATION
(continued)
Parents Name__________________________________________________________________
Affiliation with NJWC___________________________________________________________
Provide any further information or references that might present a more complete understanding of yourself and your educational and career aspirations and present an understanding of any pages or information that are being attached to this application.
I certify the accuracy and honesty of the responses entered upon and attached to this application form and agree to inform the Financial Aide Offices (or the equivalent thereof) at my college of any funds awarded to me from the NJWC Scholarship Fund as soon as possible after I have received notification concerning such funds. I authorize the release of information from my school records (both high school and college) deemed necessary to aide in the review of this application.
_____________________________
Signature of Applicant
I have checked the accuracy and honesty of the responses entered upon and attached to this application form and authorize the release of information from my child’s school records (both high school and college deemed necessary in the review of this application.
_____________________________
Signature of Parent
General Information and Instructions: Education was one of the founding principals of the North Jersey Water Conference (NJWC). We therefore provide on the order of $1000 of scholarship funds each year to worthy applicants to assist in funding their education. This application should provide the members of the NJWC Scholarship Committee with an understanding of the applicants personal and educational background. Much of the information to be presented is to be developed by the applicant and appended to this form. Forms must be submitted (or post marked) no later than the 15th of November. Applicants will be notified by early December and presentation of the Award(s) will occur at the NJWC Holiday Party in December of each year. Mail completed applications to:
Mauro M. Bacolo
Crew Engineers
1250 Route 23 North
or contact any of the NJWC Trustees with any questions regarding this application.