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Return to Mrs. Lisa Toldi in the CHS Guidance Office by Wednesday, April 11, 2018….Thanks!
Eligibility: Please attach:
n 3.0 GPA n Resume (include honors and activities)
n 25 or above ACT n Transcript (unofficial is acceptable)
n Enrolling in four-year college n College acceptance letter
n Evidence of school and community involvement
Name: _______________________________________________________________________________
Address: _____________________________________________________________________________
City: __________________________________ State: _____________________ Zip: _______________
Home Phone: (_____) _______-_________ Cell: (_____) _______-_________
Father/Guardian’s Name: _______________________________________________________________
Occupation: __________________________________________________________________________
Mother/Guardian’s Name: ______________________________________________________________
Occupation: __________________________________________________________________________
College/University you plan to attend: _____________________________________________________
Academic Average: _____________________________ GPA: ________ Class Rank: ______________
ACT (composite): __________________ SAT (verbal): __________________ (math): _______________
I, hereby, authorize the Twentieth Century Club to review my high school records.
___________________________________________________ ____/_____/18 Student Signature Date
Mary Louise Scholarship Application *** 2017-2018 *** $1,000
Application Deadline – Wednesday, April 11, 2018