SS Peter & Paul at 434 High Street, Ionia, MI 48846 US - Youth Scholarship Application

This application should be completed by applicants interested in applying for financial aid to attend youth camps and events requiring payment. It is designed to offer financial assistance based upon individual need. Parent or Legal guardian knowledge as well as approval signature is required.

Date: _____________

Name: ____________________________________________________________

Present Address: ___________________________________________________

Home Phone: ________________ Cell Phone: ___________________________

Date of Birth: ________________ Sex:_____ Male ______ Female

Name of Organization or Event requesting financial assistance for:

_________________________________________________________________

Date(s) of event: ___________________________________________________

How did you learn about this event? ____________________________________

How do you feel you will benefit by attending this event?

What gifts or talents do you anticipate being able to bring back to our parish community?

_________________________________________________________________

Referred to the Scholarship Fund by: ___________________________________

Other activities you are involved in: ____________________________________

Personal References

Name: _______________________ Name: ___________________________

Address: ______________________ Address: _________________________

______________________________ ________________________________

Telephone: ____________________ Telephone: _______________________

How long have you known this person? How long have you known this person?

_______________________________ ________________________________

Applicant’s Statement

The information contained in this application is correct to the best of my knowledge. I authorize any references listed in this application to give you any information they may have regarding my character.

Applicant’s Signature: ____________________________ Date: _____________

Parent’s Signature: _______________________________ Date: ____________