APPLICATION - SECTION ONE
CONTACT AND ACADEMIC INFORMATION
Scholarship Year _______
Name _______________________________________________________
Home Address ________________________ City _________ ST __ Zip _______
School Address ________________________ City _________ ST __ Zip _______
Phone ____________ Mobile ___________ E-Mail ________________________
School you are presently attending ___________________ Academic Year ______
Projected Graduation Date _______________
GPA _____________ ACT/SAT Score __________
Official Transcript must be attached
I hereby confirm that the information I have provided in this application is
accurate and correct.
Signed ___________________________________ Date ________________
SPONSOR INFORMATION
Name _________________________ Organization ___________
Home Address ________________________ City _________ ST __ Zip _______
I hereby attest that the above applicant in my __________
Signed ___________________________________ Date ________________
Choctaw Detachment
Marine Corps/Reserve