Sons of Norway Vegas Viking Lodge 6-1522021 Scholarship Application

You must be of Norwegian descent or a member of the Vegas Viking Lodge 6-152 or child/grandchild of a member of the lodge; a legal resident of Clark County, Nevada; at least a senior in high school; and you must maintain full-time student status to be eligible for this scholarship. The scholarship must be used for post-high school studies. Please clearly print or type all information. All questions must be answered. Failure to answer any question on this application will negatively affect its evaluation.

The following items must be included to be eligible for selection: A. Transcript(s) of grades from this current year with cumulative grades to date. B. A photocopy of your driver's license or other legal photo identification.

The completed application with the essay along with the above additional items must be mailed to the following address below and postmarked no later than April 9, 2021. Be sure to sign and date the end of the application. Viking Scholarship CommitteeDouglas Kittelson9866 Gray Sea Eagle AvenueLas Vegas, NV 89117-8424

Part I - Personal information:

Name: ______________________________________________________

Email _______________________________________________________ Birth date:________________________

Phone Number: _______________________________________________ Year in School:______________________

Secondary Contact Phone Number (If available): _______________________________________________________

Primary Contact Address:

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Secondary Contact Address (If available):

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Please note that responses to numbers 1 – 5 will be expanded upon in the essay.

1. Briefly describe your Norwegian Heritage and/or your connection to the Vegas Viking Lodge 6-152.

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2. List what college, university or technical school (not necessarily in Clark County) you hope to attend along with your area of study and career objectives.

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3. List your school extra-curricular activities during the past three years.

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4. List your community/employment involvement during the past three years.

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5. List any awards/honors earned in the last three years.

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Essay:

Attach a clearly printed or typed essay to cover the following items. If you use a word processor, your essay must be no more than two pages in length, 1.5 or double-spaced, in 12-point font.

A. Expound upon your response to Number One above.

B. Expound upon your journey to pursue your field of study in Number Two above and your aspirations for your future.

C. Expound upon your responses to Numbers Three, Four and Five above to include frequency, role in the activity, length of time, pertinent details and other information that will help explain the level of involvement.

Thank you for taking the time to apply for the Vegas Viking Lodge 6-152 Sons of Norway Scholarship. We wish you all the best in your endeavors to achieve your academic goals.

Please read and sign below.Under penalties of perjury, I declare that I have examined this application, accompanying attachments and statements and, to the best of my knowledge and belief, they are true, correct and complete. I also understand that the information contained in this application is subject to verification by the Sons of Norway Vegas Viking Lodge 6-152 and that any information found to be false or inaccurate may result in the denial or cancellation of any scholarship award and the requirement to return to the Sons of Norway Vegas Viking Lodge any funds awarded.

Signature:____________________________________________________________ Date:__________________