| First Name
|
|
Last Name
|
|
| E-Mail Address |
|
Phone |
|
| Street Address |
| City |
|
| State |
|
Zip Code |
|
| Date of Birth |
|
Place of Birth |
|
| Father's/Guardian's Name |
|
Occupation |
|
| Mother's/Guardian's Name |
|
Occupation |
|
| # of Children in Your Family Younger than Yourself
|
|
# of Children in Your Family Older than Yourself
|
|
| Name of High School |
|
| School Street
|
|
School City |
|
| School State |
|
School Zip |
|
| Graduation |
|
| Michigan College/Univ. You Plan to Attend
|
|
Campus City |
|
| Course of Study (Major) |
|
Course of Study (Minor) |
|
Have you been accepted
for admission? |
|
| If conditional, please list
second choice |
|
| List your
extra-curricular school activities (i.e., music, speech, dramatics, athletics or
clubs; list offices or leadership positions). (Limit: 5,000 characters)
|
|
|
| State other
ways you have served your community, including church and other institutions,
through leadership and service (be as specific as possible). (Limit: 5,000 characters)
|
|
|
List your work experience
outside of school hours or during vacations/breaks :
|
|
|
State why
you are applying for financial support and how much money you anticipate having
available this year.
(Limit: 5,000 characters)
|
|
|
| State your
college and career goals. (Limit: 5,000 characters)
|
|
|
Grade Point Average
(GPA) |
|
| Class standing Position |
|
Class size |
|
| |
