Jo Bob Hille Memorial Scholarship
2016 Application
Student Name: ______________________________________________________________
Last
First
Middle Initial
Permanent Mailing Address:____________________________________________________
Number & Street (Include Apt. No.)
City State Zip Code Country____________________________________________________
Permanent Telephone Number:__________________________________________________
(Area Code)
E-mail Address:______________________________________________________________
Social Security Number: _________________________________Sex: ___ Male ___ Female
Date of Birth:________________________________________________________________
Month
Day
Year
Your Driver’s License Number:_________________________________________________
Your Driver’s License State:____________________________________________________
Are you a U.S. citizen? (Mark one of the following.)
_____ Yes, I am a U.S. citizen (U.S. national)
_____ No, but I am an eligible non-citizen; Alien Registration No. _____________________
_____ No, I am not a citizen or eligible non-citizen
Marital Status (as of today):
_____ I am single, divorced or widowed
_____ I am married/remarried
_____ I am separated
Will you have a high school diploma or GED before you begin the upcoming school year?
Yes______
No _______
GPA on a 4.0 scale___________________________________________________________
Expected Program of Study:____________________________________________________
I have been accepted at the following Oklahoma accredited schools: ____________________
___________________________________________________________________________
I am involved at The First Tee of Tulsa in the following manner:_______________________
___________________________________________________________________________
How many hours did you work this past year at The First Tee of Tulsa?_________________
Other Activities (School Clubs/Civic Involvement):_________________________________
___________________________________________________________________________
List any and all scholarships/grants and the amounts you have received in the past
year:_______________________________________________________________________
___________________________________________________________________________
What income tax return did you file or will you file for the current year?
______ IRS 1040
______ IRS 1040A or 1040EZ
I have attached:
 Official transcript and school profile
 Essay of 500 words describing how The First Tee of Tulsa has impacted you and
how you plan in the future to apply the lessons you have learned
 Two letters of recommendation, one from a school counselor, teacher or mentor
and the other from a parent or guardian describing why I should receive the
scholarship
 A copy of my and my parents’ or guardians’ most recent tax return
Completed application and attachments must be received by The First Tee of Tulsa
Scholarship Committee at the following address: Deadline: January 15th, 2016
The First Tee of Tulsa
5223 East 41st Street North
Tulsa, OK 74115