LOUISIANA GARDEN CLUB FEDERATION, INC.
APPLICATION FOR SCHOLARSHIP

(Use this application form for all scholarships and please use the category letter and/or number and name of scholarship, for example: A-1 Anite Currault S2000.00 Scholarship)

1. Name in full -

2. Home address (City, State, Zip)
Phone and email -

3. School address (City, Zip) -
Phone and email -

4. Place and date of birth -

5. Male ______ Female _____ Single _______ Married ______

6. Are you a permanent resident of Louisiana? Yes No Parish ___________________

7. College -
Curriculum -

8. College level: Junior Senior Postgraduate

9. Last two schools attended:
1)
2)

10. List extracurricular activities:

11. Financial statement (to be attached to application).
12. References (letters from references to be attached to application).

(1) Scholastic Name
Address
(2) Civic Leader Name
Address
(3) Other Name
Address

13. Photograph (head shot) of applicant (to accompany application).




FINANCIAL STATEMENT

(All Categories)
Student information:

1 Student's annual earnings -
2 Hours worked during academic year -
3 Spouse's contribution, if applicable -
4 Other income or assets -
5 Financial assistance from parents -
6 Other financial help -
7 How has education been financed up to present time?
8 Parent's name -
9 Parent's occupation -
10 ***Parent's address & phone #
11 Any unusual circumstances affecting need for scholarship -


*** Information needed if student has to be contacted during the summer, etc.


RETURN BY JULY 1ST TO:
Dottte Hebert,
LGCF Scholarship Chairman
8720 HERMITAGE PL
RIVER RIDGE LA 70123-2718