Griswold Family Association
 
   
   
 

                                                                       

 
 
 
 

GRISWOLD FAMILY ASSOCIATION SCHOLARSHIP APPLICATION PAGE 1

Name of GFA member: must be applicant or applicant's parent _______________________________________________________________________________

Griswold Line, if known (please circle one): Edward Michael Matthew Francis

APPLICANT INFORMATION: (Please print legibly)

Name _______________________________SSN or student number______________
           Last                 First                   MI

Home Mailing Address __________________________________________________________

Home Phone ( )____________ Date of Birth _____E-mail address______________

Father or Guardian Name ________________________________________________________

Mother or Guardian Name _______________________________________________________

1. U. S. Citizen? Yes _______ No __________

2. High School(s) Attended? ______________________________________________________ 

3. High School Graduation Date ____________________

4. Institution of higher learning to which applicant's scholarship award is requested (if known; we recognize that some have college applications pending on admission results):

_______________________________________________________________________________________

Institution                                                           Location                                                                Major ______________________________________________________________________________________

5. Will you commute from home? ___ Live on Campus? ___ Off-campus apartment?________

6. Parent's or Guardian's occupation and employer:

Father _____________________________________________________________   

Mother __________________ __________________________________________

(CONTINUED ON SCHOLARSHIP APP 2)