PART I: APPLICANT INFORMATION

 

PLEASE TYPE OR PRINT

 

 

TODAY'S DATE: ______/______/______

 

 

NAME: ____________________________________________________________________________

              FIRST                               MI                     LAST

 

Permanent Address:

 

Street:______________________________________City:__________________________State:____

 

Zip Code:__________Telephone Number (____)______________ E-mail address ________________

 

Date of Birth___________________

 

PART II: EXTRACURRICULAR ACTIVITIES

 

List membership in school related organizations:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

List any activity that demonstrates community leadership or involvement (civic groups or clubs, volunteer work, etc.:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

List any awards received for school or community involvement: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

List job experience: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

PART III: SCHOOL INFORMATION

 

High School:______________________________________________________

Expected Graduation Date:___________________________________________

College you plan to attend:___________________________________________

Major Study Area:__________________________________________________

 

PART IV: ESSAY

 

Write a brief essay describing:

 

Why you will be a good investment if you are awarded this scholarship

Any experiences and background which demonstrate your dedication to the environment, conservation, or fishing and/or hunting heritage.

 

Essay must be typewritten; double spaced and should not exceed three pages.

 

PART V: LETTERS OF REFERENCE

 

Three letters of reference from teachers, counselors, community leaders, clergy, etc.

(Do Not include relatives).

 

PART VI: REQUIRED ENCLOSURES

 

Complete applications must include:

Official, sealed transcripts

Copy of current fishing or hunting license

Copy of Falcon Sportsmen Club membership

 

Essay PART VII: COUNSELOR OR PRINCIPAL SIGNATURE AND STATS.

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Signature of Applicant_____________________________________________

 

 

Please mail to: Falcon Sportsmen Club/Scholarship Committee P.O. Box 83 Auburn, NY 13021