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MURRAY
DOLLARS FOR SCHOLARS

Scholarship Application

Return to school office by April 2, 2012

Directions:

  1. Please type or print in blue or black ink.
  2. Do not put your name or other identifying details on any page except this one.
  3. Fill in all information. Incomplete applications will not be considered.
  4. Sign up in Mrs. Brown's office to have her complete and submit the Principal Form.
  5. You may submit the application online, or you may print it out and deliver/mail it to:
    Murray School Foundation
    Murray Community School
    216 Sherman St
    Murray, IA 50174

Only full time students are eligible for scholarships -- minimum of 12 credit hours.


Applicant Data

Name   Phone

Street

City   State   Zip

Certification:
In submitting this application, I certify that the information provided is correct and accurate to the best of my knowledge.

Date


For Dollars for Scholars Use Only
ID# Award Amount

Page 2 ID#

COLLEGE DATA

Educational Institution you have chosen to attend

Address of institution

Have you received a letter of acceptance?

4 Year College     2 Year College     Vo Tech College     Other

Proposed Major Field of Study

Cost of one year at this school:

Tuition
Room and Board
Books
Miscellaneous
(Please list)



TOTAL COST

Page 3 ID#

PERSONAL DATA

School Activities
Activity                Years of Participation                Leadership Position

Honors and Awards


Page 4 ID#

Community Activities
Activity                Years of Participation                Leadership Position

Volunteer Work
Activity                Position or Job                Years of Participation

Work Experience
Position                Employer                Dates Worked                Hrs/Wk

What responsibility will you take in paying for your own college?


Page 5 ID#

ESSAYS

1. In a short statement (200 words or less), describe the impact the Murray Community School and community have had on you as an individual.

2. In a short statement (200 words or less), write about an influence in your life that has inspired you, made you the person you are, and has sent you in the direction you are now heading in higher education. This can be an experience, a person, a book, an idea, a success, a disappointment, or anything else you feel has strongly influenced you.