to print out PDF of scholarship application form. - Czech Cultural ...

The completed application should be returned with an official transcript and standardizedtest scores to:Scholarship CoordinatorCzech Center Museum Houston4920 San Jacinto, Houston, Texas 77004Social Security Number: _____________________ Age: ______ Married: ______ Single: ______Full Name: ____________________________________________ Male: ______ Female: ______Home Address: __________________________________________________________________City: ________________________________ State: ___________ Zip Code: _________________Phone: (_____) _____________ U.S. Citizen: Yes ____ No ____To what college(s) are you applying? ________________________________________________Will you attend school on a full-time basis the entire academic year? _______________________Classification (scholarship year): Freshman ____ Sophomore ____ Junior ____ Senior ____What degree do you seek? _________________________________________________________For what career are you preparing? __________________________________________________What is the estimated cost of your academic year? ______________________________________How much of this amount will you pay from your savings? _______________________________What amount is your family prepared to contribute? _____________________________________What is your father’s occupation? ___________________________________________________What is your mother’s occupation? __________________________________________________Have you filed a financial aid application? _________ To whom? _________________________________________________________________________________________________________What results have you had? ________________________________________________________Have you applied for other scholarships? _________ If so, which ones? _____________________If not, why not? _________________________________________________________________Has other scholarship aid been granted to you? _________ If so, what? _____________________Do you have brothers or sisters who will be in college next year? _________If so, give age and college _________________________________________________________Does anyone in your family have the expense of a major illness? _________If so, what is the illness? __________________________________________________________Name one or more of your Czech ancestors: __________________________________________________________________________________________________________________________

Describe ways in which you have identified and communicated with the Czech community in thepast and your plans for doing so after college graduation. Pages may be added for your answers.Handwriting is preferred.Then give the completed application and transcript to a counselor, administrator or communityleader who knows you well. Include a stamped, addressed envelope and request that person tomail the application to us to arrive no later than the deadline date posted online.The Mary Karele Milligan ScholarshipRecommendationThe student named is applying for this scholarship established by Thelma Burnett Maresh, inmemory of her granddaughter, to be used by children of Czech descent.Please give any information that would guide the awards committee in determining the financialneed of this student and ways in which the application may identify with the Czech community.Signature: ______________________________________________________________________Position: _______________________________________________________________________Address: _______________________________________________________________________