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Dallas Scottish Rite Library & Museum Information and Guidelines for Scholarship Application
Dallas Scottish Rite Library & Museum Scholarship Application 2018
PERSONAL INFORMATION
LAST NAME: FIRST NAME:
MIDDLE NAME: MALE FEMALE
STREET ADDRESS:
CITY: ZIP CODE:
CELL NUMBER: HOME PHONE NUMBER:
EMAIL ADDRESS:
DATE AND PLACE OF BIRTH:
FATHER'S NAME & OCCUPATION:
FATHERS EMPLOYER:
MOTHER'S NAME & OCCUPATION:
MOTHER'S EMPLOYER:
NUMBER OF SIBLING'S AND AGES:
ARE THERE ANY SIBLING'S IN YOUR FAMILY WHO ARE IN COLLEGE:
YES
NO
HOW MANY?
ARE THERE ANY MASONIC AFFILIATIONS IN YOU FAMILY:
YES
NO
RELATIONSHIP:
NAME OF LODGE OR MASONIC BODY:
HAVE YOU EVER BEEN CHARGED OR CONVICTED OF A FELONY:
YES
NO
DO YOU SUPPORT THE CONSTITUTION OF THE UNITED STATES OF AMERICA:
YES
NO
EMPLOYMENT RECORD
LIST YOUR LAST TWO FULL TIME OR PART TIME JOBS (FT/PT)
EMPLOYER: PHONE #
TYPE OF WORK: FT
PT
EMPLOYED FROM: EMPLOYED TO:
EMPLOYER: PHONE #
TYPE OF WORK: FT
PT
EMPLOYED FROM: EMPLOYED TO:
LIFE GOALS
PLEASE PROVIDE A PERSONAL STATEMENT OF YOUR GOALS IN LIFE AND YOUR PLAN OF ACHIEVEMENT INCORPORATING YOUR EDUCATIONAL GOALS: (ADD ADDITIONAL LINES/SHEETS AS NEEDED)
EDUCATION
NAME OF GRADUATING SCHOOL:
CITY: ZIP CODE:
NAME COLLEGE OR UNIVERSITY:
CITY: STATE:
G.P.A.:
IN ACTIVITY PLEASE LIST: CLUBS, TEAMS,ORGANIZATIONS,BAND, CHOIR,TRACK ETC.
ACTIVITY:
GRADE PARTICIPATED: 9th 10th 11th 12th
BRIEF DESCRIPTION OF YOUR ROLE: IE. EDITOR, LINEBACKER
AWARDS / HONORS
ACTIVITY:
GRADE PARTICIPATED: 9th 10th 11th 12th
BRIEF DESCRIPTION OF YOUR ROLE:
AWARDS / HONORS:
ACTIVITY:
GRADE PARTICIPATED: 9th 10th 11th 12th
BRIEF DESCRIPTION OF YOUR ROLE:
AWARDS / HONORS:
ACTIVITY:
GRADE PARTICIPATED: 9th 10th 11th 12th
BRIEF DESCRIPTION OF YOUR ROLE:
AWARDS / HONORS:
ACTIVITY
GRADE PARTICIPATED: 9th 10th 11th 12th
BREIF DESCRIPTION OF YOUR ROLE:
AWARDS / HONORS:
PLEASE ENSURE THAT ALL APPLICATION PACKAGES ARE MAILED OR HAND DELIVERED TO THE FOLLOWING BEFORE THE DEADLINE DATE OF FEBRUARY 28TH 2018. DALLAS SCOTTISH RITE LIBRARY & MUSEUM 500 S. HARWOOD ST. DALLAS, TEXAS 75201