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.