THE JOSEPH R. EVERY SCHOLARSHIP FUND
Completed application and all supporting documentation must be returned to:
Your Guidance Office by Monday, March 22, 2021 or
A C&N office by Friday, March 26, 2021
Please type or print in ink.
PERSONAL DATA
NAME: _______________________________________________________________
ADDRESS: ____________________________________________________________
CITY: _____________________ STATE: _______________ ZIP: ________________
TELEPHONE: Home: (___)__________________ Cell: (___)___________________
DATE OF BIRTH: __________ EMAIL ADDRESS: ____________________________
FATHER’S NAME: _________________________ Cell: (___)___________________
OCCUPATION: _______________________ EMPLOYER: _____________________
MOTHER’S NAME: ________________________ Cell: (___)___________________
OCCUPATION: _______________________ EMPLOYER: _____________________
PARENT(S) EMAIL ADDRESS: ____________________________________________
NUMBER OF BROTHERS AND SISTERS: __________________________________
Are any of them attending college? __________ If yes how many? ________________
If so, indicate where they are attending: ______________________________________
______________________________________________________________________
If someone other than your parents financially supports you, please indicate:
NAME: ________________________ RELATIONSHIP: ________________________
ADDRESS: ___________________________________________________________
CITY: ____________________ STATE: _______________ ZIP: ________________
OCCUPATION: ______________________ EMPLOYER: ______________________
List any unusual expenses your parent or guardian has:
______________________________________________________________________
