ELLEN JOHNSON MEMORIAL SCHOLARSHIP APPLICATION

The estate of Ellen Johnson, a former Central Lyon High School instructor, through Delta Kappa Gamma, is awarding a $1000 scholarship to a 2005 girl graduate of either Lyon or Sioux County.

The Delta Kappa Gamma Society International promotes professional and personal growth of women educators and excellence in education.

Guidelines for submitting applications for the 2005 scholarship are:

1. You are to be pursing a career in education.

2. A short statement shy you would like to be considered for this scholarship, along with a record of your grade point average.

3. The scholarship will be awarded following proof that you are a full time student and have successfully completed one semester of college studies.

4. The scholarship may be used for tuition payment, books, education materials, or lodging or it may be paid to the school you attend with credit against tuition or other costs.

5. The student(s) selected by the committee will be notified by June 1, 2005.

________________________________________________________________________

Name _____________________________________________________________

Home Address ______________________________________________________

______________________________________________________

Birth Date __________________________

Social Security Number ______________________________________

Name of High School _________________________________________________

Name of College _____________________________________________________

Parents/Guardian _________________________________________________________

and Address _________________________________________________________

Please complete and submit the application by April 15, 2005 to:

Jane Baker

602 S. 8^th Ave.

Rock Rapids, IA 51246

Telephone (712) 472-2260