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STEPHENSON FAMILY SCHOLARSHIP APPLICATION FORM

For Student Majoring in Business or Health-Related Fields
Only full time students are eligible -- minimum of 12 credit hours.

Please fill out and submit the form online
or print out the form, fill it out in ink, and deliver or mail to
Murray Foundation Scholarships, 216 Sherman Street, Murray, Iowa 50174.

Completed applications must be received by April 2, 2012

Write personal information on this cover sheet only. It will be detatched and
a number assigned to each application. The Committee members will be
making awards with no knowledge of the individual identity of the applicants.

Student Name
Address
Father's Name
Mother's Name

 
By submitting this application, I certify that all information is true and accurate.

Date

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STEPHENSON FAMILY SCHOLARSHIP APPLICATION FORM

For Student Majoring in Business or Health-Related Fields

Educational Institution you have chosen to attend

Have you been accepted at this institution?

Intended major or vocational field

Cost of one year at this school:

Tuition
Room and Board
Books
Miscellaneous
(Please list)

TOTAL COST

High School Attendance:

Freshman Year Days Absent
Sophomore Year Days Absent
Junior Year Days Absent
Senior Year Days Absent
Number of Absences that were unexcused or because of suspension


What is you high school class rank? in a class of

What is your high school GPA?

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List school activities, awards and honors you have received. (Indicate if you have served in a leadership role.)

List Community activities in which you have participated. (Indicate if you have served in a leadership role.)

List any volunteer work you have done. (Include any activities relating directly to your chosen field of study.)

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

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In a short statement (200 words or less), please indicate why you have chosen business or a health related field of study.