SCHOLARSHIP APPLICATION

THE NEXT SCHOLARSHIP DRAWING WILL BE HELD ON NOVEMBER 14, 2011 AT THE DINNER FOLLOWING OUR GOLF TOURNAMENT. APPLICATION DEADLINE IS NOVEMBER 11, 2011.

COMPLETE ALL INFORMATION AND SUBMIT YOUR ESSAY WITH THIS ON-LINE APPLICATION.
Someone from the Scholarship Committee will be in touch with you soon. If you have questions please contact John Focke jfocke@powl.com

IF YOU HAVE SUBMITTED A SCHOLARSHIP APPLICATION YOU WILL RECEIVE A CONFIRMATION EMAIL. IF YOU DO NOT RECEIVE THIS CONFIRMATION PLEASE EMAIL NANCY BROWN nbrown@bellandmccoy.com

Required fields marked with an " * "
Required fields that do not apply please type NA

Type of Scholarship
	UNDERGRADUATE AWARD
	CAREER ADVANCEMENT AWARD
	HEAD-START AWARD

Applicant Info
First Name:	*
Last Name:	*
Phone Number:	*
Street Address:	*
City, State Zip:	*
Student ID#:	*
E-mail:	*

HEL Member's Information (self or parent)
Full Name:
Company Name:
Street Address:
City, State Zip:
Member E-mail:
Trade School, college or university to be attended:

Length of membership:

200 Word or less Essay:

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