IBEW LOCAL UNION 363 SCHOLARSHIP APPLICATION Yr.______
Name: ____________________________________ Phone Number: ________________
Address: ________________________________________________________________
High School: ____________________________________________________________
Name of L.U. 363 Member _______________________ Card Number ______________
Extracurricular Activities (Clubs, Athletics, Organizations, Etc.) __________________
_______________________________________________________________________
Personal Involvement (Community, Church, Etc.) ______________________________
________________________________________________________________________
Special Interests and Hobbies: _______________________________________________
________________________________________________________________________
Work Experience & Hours worked per week for two years prior to date of application: __
_______________________________________________________________________
Name(s) of college(s), to which you have been accepted/attended: __________________
_______________________________________________________________________
Tentative Field of study: ___________________________________________________
Future Goals: ____________________________________________________________
Your greatest achievement or most worthwhile experience to date: __________________
______________________________________________________________________
Do you expect to live on campus? ____________________________________________
****** FOR ADDITIONAL REMARKS USE A SEPARATE PIECE OF PAPER ******
PLEASE INCLUDE: A resume; High School/College Transcripts; personal Essay;.
DEADLINE: June 1st.
SUBMIT TO: The Scholarship Committee – 8 Taylor Lane New City, NY 10956
Mark the envelope: PERSONAL & CONFIDENTIAL: ATTENTION: Gil Heim
I hereby verify the information is true and accurate. I understand that the award will be forwarded after submission of the first semester’s paid bill to the union office.
Signed: ________________________________________ Date: ___________________