MMTA: Scholarship Foundation Application

Scholarship Foundation Application

P.O. BOX 857
AUGUSTA, ME 04332-0857
PHONE: (207)623-4128

**Application needs to be submitted no later than Mav 24. 2010.**

Applications without Transcripts will not be considered.

Final selection will be made on the basis of student's scholastic aptitude financial need and demonstrated skills.

APPLICANT

Name
Address
City
State
Zip Code
Phone Number
E-mail Address

HIGH SCHOOL INFORMATION

Name of High School Attending
City
State
Date of Graduation
Please Upload a Copy of Your High School Transcript *application will not be processed without transcript	Scan your transcripts and upload from your PC

PROSPECTIVE EDUCATION

Name of School You Will Be Attending
City
State
Field/Major
Are You Expecting Other Scholarships?	Yes No
If Yes, How Much?
From Whom?

EMPLOYER

Name
Address
City
State
Zip Code
Contact Name
Phone Number
Hire Date
Date Left Employment
Position Held
Salary/Wage
Reason For Leaving

PARENT OR GUARDIAN INFORMATION

Name(s)
E-mail Address
Name of Employer
Annual Income
Do You Have Any Siblings?
If Yes, How Many Are Attending College?

EXTRACURRICULAR

List All School Activities
List All Community Activities

VERIFICATION

*By submitting this application, you hereby authorize us to contact employer(s) and/or your parent/guardian.

* are required

Validation*

Please type the letters you see in the box above.