WOMEN IN
SCHOLARSHIP APPLICATION
Women In Longview, Inc. will award a $1,000 scholarship to an adult
woman who wishes to continue her education. The applicant should have either
a high school diploma or a GED and be interested in pursuing a field of study
at an accredited college, university, technical, or vocational school. Financial need, community involvement, and
letters of recommendation will also be given consideration. Applicants must be
Please complete all areas in
their entirety. Print or type your
responses and return the application with required documents to Women In
Longview, Inc., Scholarship Committee,
NAME:______________________________________________________ DOB: ___________
MAILING ADDRESS: __________________________________________________________
CITY: _____________________ STATE: ______________ ZIP:______________
CONTACT PHONE NUMBERS: (HOME) _____________ (WORK) ____________ (CELL) ________
EMAIL ______________________________________________________________________
Are you employed? ________________________
Where and for how long? _________________________________________________________
Describe your educational background: ______________________________________________
When did you graduate from high school, receive a GED, or obtain a higher degree? _________
Name ____________________
What work or community activities have you participated in since that time?
Describe your goals.
Name ________________
Why can we expect you to attain your goals?
Explain your need for financial assistance.
CERTIFICATION:
I certify that all information in my application packet is correct to the best of my knowledge.
MEDIA RELEASE:
If I am the recipient of a Women
in
Applicant’s Signature: ____________________________________ Date __________________