Scholarship Application Form - Veterans Of Foreign Wars And Its Ladies Auxiliary Department Of Nebraska
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2VETERANS OF FOREIGN WARS AND ITS LADIES AUXILIARY
DEPARTMENT OF NEBRASKA
SCHOLARSHIP APPLICATION
ATTENTION ALL APPLICANTS: Read instructions on reverse. **On a separate sheet of paper
attached to this application, please state, in your own words, why you feel you should receive a
scholarship award, including goals and all other supporting information.
Name ___________________________________ Address _______________________________
City ____________State ___ Zip _______ Phone (___) __________Veteran _________________
Date of Birth ____-____-____ Nebraska resident____ Marital Status :____ Dependents:___ Ages_______
Any college credit hours received in high school __________
( total 24 credit hours = 1 yr)
College Now Attending _______________________ Years Completed ___ (Must completed one (1) year.)
Name of College Accepted In ______________________Address________________________
Current Grade Average _____ Hours per semester ___ Cost per credit hour $ ____ Cost per Yr $_______
Student’s Major _________________
Student’s School Contribution $ ___________
Student Employer __________________ Income Past Year $________
Spouse's Employer ______________________ Income Past Year $_______________
Current Outside Activities _______________________________________________________
Applicant VFW/ Aux ______________
VFW/Aux affiliated member /s; _______________
Name of VFW or Ladies Auxiliary, Dept. of NE. ____________________________________
______________________________________________________________________________
Relationship__________________ Deceased____ Post/Aux Number and Location __________
Participation in VFW or Auxiliary: officer or a chairman:_________________________________
Parent's Name: ____________________________ Address_______________________________
Names and Ages of Other Dependents ________________________________________________
Parent's Net Income $_____________________
Parent's Contribution Next Academic Year $________________
Estimated ($) Needs After Grants, Scholarships, Loans, Etc. $_______________________
All Other Aid Received For Next Academic Year (Grants, Fellowships, Scholarships, & Loans)
SOURCE
AMOUNT REQUESTED AMOUNT APPROVED
DATE APPROVED
__________________ $_____________
$__________________
_______________
__________________ $_____________
$__________________
_______________
__________________ $_____________
$__________________
_______________
All VA Benefits (Per Month) $_____________
Date Benefits Terminate ____________________
Other Income (List source) $ ________________________________________________________
CHARACTER AND ACADEMIC REFERENCES:
Name _______________________________ Address ______________________________________
Name _______________________________ Address ______________________________________
All information is true to the best of my knowledge. _______________________________________
As of this date:______________________
( Signature )
(pbapsch 2013)
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