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by April 1

HAWARDEN JAYCEES SCHOLARSHIP

for

West Sioux High School Graduating Seniors

A $250 scholarship will be give by the Hawarden Jaycees. This will be paid to the institution of higher learning at the beginning of the second semester, upon successful completion of the first semester.

Application must be completed and submitted by April 1.

Name _______________________________________________________________________________

(Last) (First) (Middle)

Address _____________________________________________________________________________

(Street) (City)

Date of Birth ______________________

List and/or explain any extra-curricular school activities and years of involvement.

Describe any special circumstances which may have limited your participation in school and community activities.

GPA ____________________ Class Rank ____________________

For what careers do you plan to prepare yourself?

What plans have you made for financing your college education (savings, scholarships, loans, work etc.) If you desire, relate any special circumstances which have a direct bearing on your need for financial assistance.

Name of institutions to which you have applied.

List and explain any involvement in community activities (4-H, scouts, church etc.)