scholarship-form – Epes Randolph Lodge No. 32

Temple 51 & Epes Randolph 32 Continuing Education Fund

This fund will provide scholarships (Grant/Aid) on an annual basis.

It is open to all high school graduates for their continuing education in College,

University, Trade School and Post-Graduate endeavors.

The scholarships will be up to 53000.00 each.

A minimu m of tZ credit hours required to be considered.

Use the attached application form.

Please type or print when filling out the application. lf it is illegible it will be returned.

Please enter N/A if answer is not applicable.

Use the back of the form if there is not enough room.

Use the back of the form or attach a separate sheet with any additional information you would like to share with the selection committee.

Applications will be accepted beginning January 2 thru February 29,2024.

Scholarship awards will be sent to your school of choice no later than March 29, 2024.

Last Name

First Name

Mailing Address

Street

City

State

Zip

Daytime Telephone Number

Date of Birth

Current High School

Number of years attended

I will be attending ( in the Fall of 2023 )

School Name (Minimum 12 credit hours)

Proof of acceptance or current enrollment from the school is required prior to receipt of funds.

I will be entering the above school as a

Grade point Average (GP)

Attach proof. ( Most recent official school transcript required. )

ACT Score

SAT Score

Extracu rricular activities:

Name & address of parent(s) or legal guardians(s): Use reverse side of application if you need more space.

Name (s):

Street

City

State

Zip

Home'phone number of parents or guardians

Name and city of other high schools attended

Number of years attended

What specialty / major do you plan to major in as you continue your education?

Tuition ( Amount $ )

Books ( Amount $ )

Room & board ( Amount $ )