Please mail transcripts to:
Required items:
Completed application form
School transcript
Two (2) completed recommendation forms
PLEASE TYPE ALL INFORMATION REQUESTED (check boxes)
Please select the scholarships of your choice:
Vineland Rotary Harry D. Doerr Scholarship John Spoltore/Matt Blatt Most Inspirational Scholarship Harry Kejzman Scholarship Vineland High School William F. Dudley, Sr. Memorial Scholarship Vineland High School Otto Schwabe Memorial Scholarship Sacred Heart High School Msgr. Joseph G. Stoerlein Scholarship Rev. C. Ross Collins Scholarship Leslie N. Kotok Scholarship Shaye Kotok Scholarship The Grapevine's Hometown Heroes Scholarship
Full Name: (Last, First, MI)
Birth Date: (mm/dd/yyyy)
Citizenship status:
Residency status:
Gender:
Current address:
Permanent Address: (if different)
Home phone: (numbers only)
Work/School phone:
E-mail address:
High school:(attending or graduated from)
High school Address:
Date of high school graduation: (mm/dd/yyyy)
SAT Score: Verbal:
Current High School Class Rank:
GPA:
Father’s name:
Father’s address:(if different from yours)
Father’s Employer:
Father’s Occupation:
Mother’s name:
Mother’s address:(if different from yours)
Mother’s Employer:
Mother’s Occupation:
Do your parents
What is the marital status of your parents?
Number of Siblings:
Their Ages:
How many siblings are in college?
What year will they be in for 2010-2011?
What colleges do they attend?
Where have you applied?
Your first choice of college:
Total cost per year:
Your intended major:
Your career goal:
List Summer job(s) you had in the summer of 2009
List Summer job(s) planned for the summer 2010
Do you work?
If yes, where?
What is YOUR financial contribution toward your expenses? (numbers only)
Expected assistance from parents/family: (numbers only)
Scholarship work study:
Grants/Scholarships:
Work study:
Loans:
List extra-curricular activities, clubs, sports, and offices held, including any community service.
Freshman year:
Sophomore year:
Junior year:
Senior year:
Please describe any special family circumstances you wish to explain in 150 words or less: Type in box below (COUNT – Max 1500 letter)
Provide an essay of 250 words or less, stating your career objectives and area of pursuit. This essay must be specific to the scholarships of your choice (COUNT – Max 2500 letter)
Recommendation Forms:The official Recommendation Form must be completed electronically.
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