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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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