PATRICIA & LEONARD KRAMER

MEMORIAL SCHOLARSHIP

APPLICATION

Name_ญญญญญญญญญ____________________________________

Home Address__________________________________________________

STREET CITY ZIP

Phone ______________________ Email ___________________________

Guardian’s Name(s)______________________________________________

Resident of Adams County ______YES_______NO

What college do you plan to attend? ________________________

1) Provide three copies of a short essay about some service involvement, how you became involved, what you gained, and how it relates to your career goals.

2) List school activities in which you are involved: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3) List volunteer activities in which you are involved:

____________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________

4) List your career goals:

______________________________________________________________________________

5) List any employment you have had:

______________________________________________________________________________

_____________________________________________________________________________________________

Send three copies of the completed application, three copies of letters of reference from three different individuals sealed by the authors, and one official copy of your high school transcript to: Altrusa International of Quincy, IL, PO Box 733, Quincy, IL 62306.

(12/2009)