scholarship application
Directions: Return the following application by
regular mail or by email to: Diane Blankenship, 354 Pleasant Grove Road,
Jackson, OH 45640. [email protected]
If you are unable to print this page, email Mrs.
Blankenship and request an application be emailed to you.
Deadline: MAY 31, 2024
Name of College or University:
Address of College or University:
Name of Applicant:
Address of Applicant:
Phone Number of Applicant:
Name of High School from which applicant
graduated:
High School Graduate Date:
College/University Major:
Present Cumulative GPA:
WHAT YEAR OF SCHOOL (University or College) WILL YOU BE IN THE FALL OF 2024 (circle one)
junior senior
List activities, professional affiliations, etc.
in which you are or have been involved:
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List any jobs that you presently hold or have
held, both on and of campus:
If you have financial need, explain briefly:
If you have any unusual items or expenses or
special family circumstances which the committee should consider, please
explain:
Briefly explain why you selected teaching as a
career and what goals you have set for yourself: