WILLENE DAVIS SCHOLARSHIP
APPLICATION FORM

Year 2, 3, or 4 - Student Application - Student Majoring in Health, Education, Business, or Agriculture related fields.

Please fill out this online form and submit no later than April 2, 2018.
Failure to complete all information required will result in disqualification of applicant.
This cover sheet will be detached from the student's application and a number assigned.
Selection will be made with no knowledge of the individual identity of the applicants.


Student Name:
Address:
City:   State:   Zip:

Telephone Number:

I hereby certify that all information contained in the following application is true and accurate.
Certified by (student name):   Date:

For Foundation Use Only:   ID#


Page 2 ID#

WILLENE DAVIS SCHOLARSHIP APPLICATION FORM
Year 2, 3, or 4 Student Application

Educational institution you are currently attending?

Will you be attending the same institution next year?

If no, what college will you attend?

Address of college you will be attending next year:

Year in college next year?

Major or course of study?

Cost of one year at this school?

Tuition
Books
Room and Board
Miscellaneous
(Please list)


TOTAL COST

Include an official college transcript for your first year of college.
Provide 2 letters of recommendation from your college instructors, in which they comment on your attitude, work habits, diligence and quality of work.
Send the recommendations and transcript no later than April 2, 2018, to:

Murray School Foundation
Box 187
Murray, Iowa 50174


Page 3 ID#

College Activities, Awards, Honors (Please indicate if you have served in a leadership role.)

Which high school award you received or activity you participated in was most meaningful to you? Please explain the reasons for this choice.

Have you done volunteer work? If so, please describe.

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

In a short statement (300 words or less) please explain why you are deserving of this scholarship.