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Daniel Logan Memorial Scholarship Application

 

Name:_______________________________________  Date:____________________

Home address: _______________________________  Phone:____________________

City:______________________  State:_____________  ZIP code:_________________

 

Check one:

[  ]   I am currently enrolled at _____________________________________
                                                            (Name of school)

[  ]   I have been admitted to ______________________________________
                                                          (Name of school)

[  ]   I have applied for admission to__________________________________
                                                                  (Name of school)

 

Are you expecting to receive a scholarship from another organization? _______________

Are you expecting to receive other financial assistance through grants/loans?___________

If yes, please list the dollar amount of the scholarship(s), grants, and/or loans you expect to receive.  In addition, include the name and phone number of the organizations(s) awarding any/all of the above.

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

_________________________________________________________

 


TO BE COMPLETED BY COUNSELOR, PRINCIPAL OR OTHER SCHOOL OFFICIAL

ACT score_______  SAT score______  Class ranking______  Class size_______

Grade-point average_______

 

School official:

Name:________________________________________   Date:_________________

Title:________________________________   School district:___________________

County:________________________ Work phone number: (_____)______________

 

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