OUR LADY OF PERPETUAL HELP CATHOLIC CHURCH
SCHOLARSHIP APPLICATION FORM
Scholarships are awarded on the basis of financial need, scholarship and participation in Parish activities.
NAME__________________________________________________________ DATE OF BIRTH____________
HOME ADDRESS __________________________________________ HOME PHONE NUMBER ___________
Current e-mail address _______________________________________
HIGH SCHOOL GRADUATED FROM ____________________________________________________________
YEAR OF GRADUATION _________________________
NAME OF SCHOOL YOU PLAN TO ATTEND NEXT SCHOOL YEAR ___________________________________
COURSE OF STUDY YOU PLAN TO FOLLOW _____________________________________________________
PLEASE STATE THE EXTENT YOU HAVE BEEN IINVOLVED IN YOUR PARISH, AND/OR YOUTH GROUP
ACTIVITIES:
PLEASE STATE YOUR REASON FOR APPLYING FOR A SCHOLARSHIP FROM OUR LADY OF PERPETUAL HELP
CHURCH:
Applicants are informed that the Scholarship Committee allows scholarship money to be used for internet classes for
students enrolled as full time students (12 semester hours). Under special and extenuating circumstances, and based on
the availability of funds scholarship applications may be considered for internet classes taken on a part time basis (less
than 12 semester hours). These applications must also be received by the committee by the announced deadline for all
other applications.
Please complete the application information on the following page.
Page 2 OLOPH Scholarship Application Form
PLEASE LIST BELOW THE NAME OF ONE MEMBER OF THE PARISH, ONE TEACHER, AND ONE OTHER
REFERENCE THE COMMITTEE MAY CONTACT:
PARISH
MEMBER ________________________________________
ADDRESS ___________________________________________________ PHONE # _________________
TEACHER ________________________________________
ADDRESS ____________________________________________________ PHONE # _________________
NAME ____________________________________________
ADDRESS ____________________________________________________ PHONE # _________________
SIGNATURE OF APPLICANT _____________________________________
DATE ______________________
SIGNATURE OF PARENT OR GUARDIAN ____________________________________
DATE _______________________
A CURRENT HIGH SCHOOL TRANSCRIPT AND RECENT PHOTO MUST BE SUBMITTED WITH THIS
APPLICATION
COLLEGE STUDENTS SHOULD SUBMIT THEIR MOST RECENT OFFICIAL TRANSCRIPT.
ALL APPLICATION MATERIAL IS DUE TO THE PARISH OFFICE ON OR BEFORE
APRIL 23, 2012