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Violet Township Women’s League

2018 Application

Applicant’s Name: _______________________________________________

Home Phone Number: __________________ Cell Phone Number: _____________________

Birth Date: __________________________

Address: _______________________________________________________

Resident of: (Check all that apply) _____ Pickerington Local School District _____ Violet Township

High School: _____ Pickerington Central _____ Pickerington North _____ Other_______________________

(Unweighted) Grade Point Average: __________

Parent/Guardian: ______________________________________________

Preferred Institute of Higher Learning: __________________________________________________________

Address___________________________________________________________________________________

Intended Major: _______________________________________________

Interests and Extra Curricular Activities: (Attach a separate sheet, if necessary) __________________________________________________________________________________

__________________________________________________________________________________

Community Service Experience: (Attach a separate sheet, if necessary, and include the average time spent per month on each activity listed) __________________________________________________________________________________

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How did you learn about the VTWL Scholarship? ________________________________________________

I agree that all submitted information is true and accurate.

Student Signature_________________________________________

Parent/Guardian Signature___________________________________

****************************************************************************************** Committee Checklist:

_____Application _____Essay _____ 2 Letters of Recommendation _____Proof of Admission

Application Deadline

Please submit your completed application and all supporting documents as soon as possible to: Violet Township Women’s League, P.O. Box 384, Pickerington, OH 43147. All applications and supporting documents must be postmarked no later than  03/31/2018 .