elizabeth g. dorsett memorial scholarship - Girl Scouts of Eastern ...

Application Application for Elzabeth G. Dorsett Memorial Scholarship 4
Reference Form for 2011 Scholarships
Applicant’s name: ______________________________________________________________________
Reference name: ______________________________________________________________________
Address: ______________________________________________________________________________
City/State/Zip _________________________________________________________________________
Reference’s signature __________________________________________________________________
In what capacity do you know the applicant?
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How long have you known this applicant?
______________________________________________________________________________________
Please describe this applicant’s character and involvement in Girl Scouting, school and/or her
community. Attach an additional page if needed.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
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Applications and references must be received by January 15, 2011 at 5:00 p.m.
Faxes not accepted.
GSEP Awards and Scholarships
Attn: Joan Hannahoe, 2633 Moravian Avenue, Allentown, PA 18103
Call 610.791.2411, ext. 1509 or email jhannahoe@gsep.org