Bob Carlson Memorial - Kirksville Public Schools

Harry Farr Memorial
Scholarship Application
Student Name ______________________________________________________________________
Student Address ____________________________________________________________________
Parent/Guardian ____________________________________________________________________
Father’s Occupation _________________________________________________________________
Mother’s Occupation ________________________________________________________________
Number of siblings older than you ____________ Number of siblings younger than you __________
What college do you plan to attend? _____________________________________________________
Do you plan to commute from home? __________ If not, where do you plan to live? _____________
You may use additional pages for the following responses if needed.
Please list all other scholarships, awards or financial aid for which you have applied or have been granted
for the coming year
Name of scholarships or financial aid
Has been granted
What are your educational plans, your intended major and career goals?
Briefly summarize your school, church and community activities. List organizations of which you are a
member and offices held.
Why do you wish to be considered for this scholarship? (Please note any other financial considerations.)
The applicant herewith consents that the scholarship selection committee be fully informed as to the
applicant’s scholastic standing, character, and other factors having a bearing on this application.
Signature of Applicant