Cal Ellis Memorial Scholarship Awards Program

Officially Authorized Application

Year 2005 Competitions

Two $1,500 First Prizes

Two $500 Runner-up Prizes

If, based on the following criteria, you feel you are eligible for this competition, and wish to apply for it, please fill out the form below, and to the extent you can, complete the questionnaire:

1. You are either a recent graduate of, or currently a senior in high school, in good academic standing and will include your high school transcript with this application.

2. You have already made arrangements to continue into higher education when you graduate high school, and can verify this through written proof from the school where you have been accepted.

3. If you are one of the winners of this scholarship awards program, both you and your parents or guardians agree to participate in public relations coverage of the presentation of the award, including photographs and possible media involvement.

 ____________________________________________________________
Name of parent/guardian verifying information

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Signature of parent/guardian

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Applicant's name

____________________________________________________________
Applicant's signature

____________________________________________________________
Date of application

____________________________________________________________
Address

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City/State/Zip

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Telephone

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School presently attending and phone number

____________________________________________________________
School to be attended next semester and phone number


In addition to the other information requested, please enclose a minimum of two letters of recommendation from people who know you well and can vouch for your being deserving of this award.

NOTE: Do not separate this information from the questionnaire that follows. Submit both items, postmarked no later than August 31, 2005, to:

ANJRPC Scholarship Awards Committee

c/o Mike Cutrera

Regional Vice President/Scholarship Awards Chairman

2560 U.S. Highway 22

P.O. Box 147

Scotch Plains, NJ 07076

 

Please fill out the questionnaire to the best of your ability