APPLICATION FOR SCHOLARSHIP

Personal Information

NAME
PRESENT ADDRESS (City, State, Zip)
PERMANENT ADDRESS
TELEPHONE NUMBER
E-MAIL ADDRESS
ARE YOU 18 YEARS OR OLDER?	Yes No
HOW DID YOU HEAR OF THE SCHOLARSHIP?

Education

SCHOOL LEVEL	NAME AND LOCATION OF SCHOOL	NO. OF YEARS ATTENDED	DID YOU GRADUATE? (Yes/No)
HIGH SCHOOL
COLLEGE
GRADUATE SCHOOL
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL

Organizations

PROFESSIONAL, SOCIAL, CAMPUS
SPECIAL TRAINING
SPECIAL SKILLS

References       

NAME	TELEPHONE	RELATION	YEARS ACQUAINTED

Essay

ESSAY-“WHY I WANT TO BE A CONSULTING CIVIL ENGINEER” (500 word minimum)

Certification

I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF AWARDED THIS SCHOLARSHIP THAT FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR RESCINDING THE AWARD.
Date
Name (will take the place of signature)