Longwood University Alumni Association
Legacy Scholarship Application – New Student
Name: ________________________________________________________________________
Address: ______________________________________________________________________
Street
______________________________________________________________________
City
State
Telephone #: ___________________
Zip Code
Email Address: _________________________________
Father’s Name: _________________________________________________________________
Father’s Address: _______________________________________________________________
Street
City
Zip
Father’s Occupation: _____________________________________________________________
Mother’s Name: _________________________________________________________________
Mother’s Occupation: _____________________________________________________________
Mother’s Address: _______________________________________________________________
Street
City
Names and Ages of Siblings:
_________________________________
Name
Age
Zip
_________________________________
Name
Age
_________________________________
_________________________________
Name
Name
Age
Age
Name of parent who is an alumna/alumnus: ___________________________________________
Class year of parent who is an alumna/alumnus: _______________________________________
Email address of parent who is an alumna/alumnus: ____________________________________
What is the last school you attended? ________________________
High School GPA: __________
High School Class Standing: _________ out of ________
On a separate sheet of paper, answer the following questions:
1. List the organizations and activities in which you have participated and any awards or honors
you have received.
2. Based on your prior experiences, how do you anticipate being a citizen leader while you are a
student at Longwood University?
Return this form to: Alumni Legacy Scholarship Committee, Longwood University Alumni
Association, 201 High Street, Farmville, VA 23909, by June 15.