Name:

 

 

 

 

Last

First

Middle

 

 

Mailing Address:

 

 

Street                          City                  State             Zip

 

 

Home Address:

 

 

  (if different)

   Street                         City                   State             Zip

 

 

 

Telephone Number:

 

 

Social Security Number:

 

 

 

 

 

 

 

High School:

 

 

GPA:

 

 

 

School you plan to attend:

 

 

 

List Activities Participated in:

 

 

 

 

 

 

 

 

 

 

 

 

 

Father or Guardian:

 

 

 

 

 

Last

First

Middle

Mother or Guardian:

 

 

 

 

Last

First

Middle

 

I certify that to the best of my knowledge the information provided in this application is true and correct.

 

Applicant’s Signature:

 

 

Date:

 

 

VERIFICATION OF SCHOOL RECORDS AND ACTIVITIES

I have reviewed this application and according to our records, I find it to be true and correct.

 

Signature:

 

Date:

 

 

Principal or Counselor

 

 

 
 

Essay Questions:

 

Explain your career aspirations and your educational plan to meet these goals.

 

 

 

 

 

 

 

Describe a challenge or obstacle you have faced in the last 5 years.
What did you learn about yourself from this experience?

 

 

 

 

 

 

Do you feel your current grades are an acute index of your ability?

If not, what factors prevented you from doing better?

 

 

 

 

 

 

What have been your favorite recreational activities and/hobbies?

 

 

 

 

 

 

By accepting this scholarship you give us permission to share a photo and make an

appearance, if possible, at the following years car show.   Signature

 

 
Class of 201$1,000 Diesel/Automotive Scholarship Eligibility & Application Requirements:

*Applicant must be a graduating high school senior this year;

*Applicant must have 2.5 GPA;

*Applicant must provide high school transcripts;

*Applicant must provide two character references;

*Applicant must provide completed application;

*Application must be returned by April 15, 2011.

Return packet to: Aaron Lambert Memorial Scholarship P.O. Box 1507  Eagle Point, OR. 97524  Call 541-531-2145