The Falcon Sportsmen Club Scholarship Award

PART 1: APPLICANT INFORMATION

PLEASE TYPE OR PRINT

Today’s Date: ______/______/______

Name___________________________________________________________

FIRST MI LAST

Permanent Address:________________________________________________

City:_______________________State:_______________Zip Code:__________

Telephone Number (____)______________ E-mail address ________________

Date of Birth___________________

PART II: EXTRACURRICULAR ACTIVITIES

List membership in school related organizations_____________________________________________________________________________________

._________________________________________________________________________________________________________________________

List any activity that demonstrates community leadership or involvement (civic groups or clubs, volunteer work, etc.___________________________________

._________________________________________________________________________________________________________________________

List any awards received for school or community involvement __________________________________________________________________________

._________________________________________________________________________________________________________________________

List job experience __________________________________________________________________________________________________________

._________________________________________________________________________________________________________________________

PART III: SCHOOL INFORMATION

High School _________________________Expected Graduation Date _______

College you plan to attend __________________________________________

Major Study Area__________________________________________________

PART IV: ESSAY

Write a brief essay describing:

· Why you will be a good investment if you are awarded this scholarship

· Any experiences and background which demonstrate your dedication to the environment, conservation, or fishing and/or hunting heritage.

· Essay must be typewritten; double spaced and should not exceed three pages.

PART V: LETTERS OF REFERENCE

Three letters of reference from teachers, counselors, community leaders, clergy, etc. (Do Not include relatives).

PART VI: REQUIRED ENCLOSURES

Complete applications must include:

· Official, sealed transcripts

· Copy of current fishing or hunting license

· Copy of Falcon Sportsmen Club membership

· Essay

PART VII: COUNSELOR OR PRINCIPAL SIGNATURE AND STATS

._________________________________________________________________________________________________________________________

. ._________________________________________________________________________________________________________________________

Signature of Applicant_____________________________________________

Please mail to:

Falcon Sportsmen Club/Scholarship Committee

P.O. Box 83

Auburn, NY 13021