http://mt_view_244_010.htm This web site has been created with technology from Avanquest Software. Fri, 26 Feb 2010 17:04:52 GMT Web Easy by Avanquest Software Mountain View Odd fellows Lodge No. 244 Application for Scholarship Name: ________________________________________________Phone Number: (________)__________________ Address: _____________________________________________________________________________________ School:_______________________________________________________________________________________ Father’s Name: ___________________________________________________________ Occupation Where Employed: _________________________________________________ Mother’s Name: ___________________________________________________________ Occupation Where Employed: _________________________________________________ Are your parents Married or Divorced: ____________________________________________ Is either one or both of your parents deceased? Father: ____ Mother: ____ Are You Supported by Both Parents? Yes____ No____ If Answered “No” Please specify who your Primary Source or Support is: Mother: _____ Father: _____ Other: ______________________________________________________ Ages of Brothers and Sisters: ____________________________________________________________________________ What College Do You Plan To Attend? List in order of preference: _________________________________________________ ___________________________________________________________________________________________________ Have You Applied For Other Scholarships? Yes_____ List Your School Activities: Clubs, Honors, Awards, etc.: ________________________________________________________ ____________________________________________________________________________________________________ Outside of School Activities and Jobs Held: __________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ Page 1 http://mt_view_244_010.htm Fri, 26 Feb 2010 17:04:52 GMT Web Easy Professional Avanquest Software http://mt_view_244_010.htm#1