B.P.O. ELKS NO. 1954
508 Main Street
Presque Isle, Maine 04769
Tel. (207) 764-0985
PAST EXALTED RULERS ASSOCIATION
FOR HIGH SCHOOL SENIORS ONLY
Any student in the graduating class of a high school, who is a resident within the
jurisdiction of the Presque Isle Elks Lodge # 1954, may file an application. All applicants must
be citizens of the United States of America on the date the application is filed.
The application must be filed with the Lodge Scholarship Chairman or President or
Secretary of the Past Exalted Rulers Association, having jurisdiction in the area in which the
student has legal residence.
The FINAL DATE for filing completed applications with the Past Exalted Rulers
Association is May 1, 2015
Financial need, leadership, and scholarship are the criteria by which applicants will be
judged.
The following Merit Standards will be judged:
A. Financial Need
B. Leadership
C. Scholarship
Total:
200 points
350 points
450 points
1000 points
B.P.O. Elks Scholarship Application
B.P.O. ELKS NO. 1954
P.O. Box 1083 508 Main Street Presque Isle, Maine 04769
Scholarship Application
NAME
Sex:
ADDRESS
PHONE
Date of Birth:
Social Security #
Age
Schools Attended (Ninth through Twelfth Grade
Date will Graduate:
Number in Class:
Rank in Class:
Leadership Activities
Honors and Awards:
School Related Extra-Curricular Activities
Have you been granted Scholarship aid? Yes
No
Have you reason to expect aid from any other source? Yes
Are you currently working?
No
Give Details:
What are your earnings, savings, etc.
B.P.O. Elks Scholarship Application
Parental Financial Analysis
Father’s Name
(Stepfather)
Age:
Occupation:
Mother’s Name:
(Stepmother)
Age:
Occupation:
Father’s Annual Income
$
Mother’s Annual Income:
$
Other Income:
$
Parents adjusted Gross Income $
Date: _
___________________________
Father (Stepfather) Signature: ____________________________________________
Mother (Stepmother) Signature____________________________________________
This application must be accompanied by the following:
1. Official high school transcript of student’s grades from the beginning of the 9th grade to the
date of application.
2. SAT and ACT test scores.
3. The applicant shall prepare a statement of 300 words or less setting forth his/her vocational or
professional goals and relate how past, present and future activities make the accomplishment of
this goal probable. This letter must be signed.
4. Current dated, signed – one page letters of recommendation from at least one person, in
authority for high school attended by applicant. Letter may cover the applicant’s ability, work
habits, leadership, personality, and integrity.
5. The parent/guardian shall prepare a statement of 200 words or less summarizing the family’s
obligations and resources. The statement needs to illustrate the applicant’s need for financial
assistance and the inability of the family to satisfy these needs. This statement must be signed.
B.P.O. Elks Scholarship Application