Hanover County Public Schools
Date of Birth:
Social Security #: Date of Birth:
E-mail address (optional): Telephone:
Fatherís Name: Occupation:
Motherís Name: Occupation:
Class Rank: Cumulative GPA:
Name of institution you plan to attend:
Elementary School Attended:
Name of subdivision or town you live in:
Have you ever participated in any Youth Athletic Program other than your school athletic program?
If so, what was the name of the program?
Attach a brief essay (100 words) describing your educational goals and why you feel you deserve financial assistance to continue your education.
This completed application will qualify seniors for scholarships provided by area businesses and organizations through the schoolís Scholarship Committee. Some organizations may request that your application be distributed for their review. By signing this form, you and your parent give permission to distribute this application for scholarship consideration.
Student's Signature Parent's Signature (if student is under 18) Date