Education Association of South Hackensack Memorial School

Education Association of South Hackensack
Memorial School Scholarship
Conditions and Qualifications for Award:
Scholarship(s) will be awarded to graduating high school student(s), who is (are) current
resident(s) of South Hackensack, who received a diploma from South Hackensack
Memorial School, having attended at least one year at Memorial School. The
scholarship award is for attendance at a post-secondary school or college/university.
Basis for award
 Grade Point Average
 School Clubs/Activities
 Awards and Achievements
 Community Service
Deadline
Application deadline is April 22, 2016.
Award Announcement and Payment
Scholarship Award(s) will be announced in June and the awards will be made at
Memorial School’s grammar school graduation. Announcement of the Scholarship
Award will be made by letter and published in the local newspaper.
Administration
Applications:
 are sent to High School Guidance Departments
 are available at Memorial School
 can be downloaded at www.shmemorial.org
Education Association of South Hackensack Memorial School Scholarship
Deadline: April 22, 2016
(ALL fields MUST be completed)
Student's Name:___________________________________________________________
Date of Birth: ______________________
Address:_________________________________________________________________
Phone Number:____________________
Applicant ranks ___________ in a class of ________.
SAT Scores:__________
Verbal:____________ Mathematics:____________
Father's Name:____________________________________________________________
Occupation:_________________________________
Income:____________________________________
Mother's Name:____________________________________________________________
Occupation:_________________________________
Income:____________________________________
Marital Status of Natural Parents:
Married_____
Separated____
Divorced_____
Number of Brothers & Sisters:___________
Ages:___________
List scholarships for which you have applied:
1 Dyer Avenue, South Hackensack, NJ -7606 / (201)440-2782 / www.shmemorial.org
Why do you seek/need this scholarship?
List School Activities:
Activity
Office Held hours/Awards Received
Grades/Dates
List Community Activities
Activity
Office Held hours/Awards Received
Grades/Dates
1 Dyer Avenue, South Hackensack, NJ -7606 / (201)440-2782 / www.shmemorial.org
Employment
Employer
Type of Work
Hours/Week
Dates
List 3 post-secondary schools and/or colleges/universities (in order of preference) to which
you have applied:
1.______________________________________
2.______________________________________
3.______________________________________
What is your planned major area of study?________________________________________
Write a brief statement (limited to the space below) describing your views about service and
your efforts in providing service to the school and/or community.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
1 Dyer Avenue, South Hackensack, NJ -7606 / (201)440-2782 / www.shmemorial.org
Write a brief statement (limited to the space below) describing your career goals and how you
expect your education will help you attain them.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
The information contained herein is complete and accurate to the best of our knowledge.
Applicant's Signature:________________________________
Parent's Signature:__________________________________
Date:__________________
Date:__________________
**Please attach a copy of your transcripts. Submit all the
paperwork to the Memorial School main office.
1 Dyer Avenue, South Hackensack, NJ -7606 / (201)440-2782 / www.shmemorial.org
1 Dyer Avenue, South Hackensack, NJ -7606 / (201)440-2782 / www.shmemorial.org
1 Dyer Avenue, South Hackensack, NJ -7606 / (201)440-2782 / www.shmemorial.org
1 Dyer Avenue, South Hackensack, NJ -7606 / (201)440-2782 / www.shmemorial.org

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