Mack Scholarship Application Form

MACK INDUSTRIAL SCHOOL CORPORATION SCHOLARSHIP APPLICATION FOR GRADUATING SALEM GIRLS
The Mack Industrial School Corporation Scholarship is for young women who are
residents of Salem, graduating from high school and continuing on to college. The
scholarship is awarded based on a combination of financial need and academic
performance, and can renew annually during your four-year pursuit of an undergraduate degree.

To be considered, applicants must submit this form by May 1.

To be eligible for the scholarship, applicants must meet the following conditions:
1. Have a permanent address in Salem at the time of the application and high school graduation.
2. Complete the application, answering all of the questions and attaching all of the requested documents.
3. Maintain a primary residence in Salem for the duration of college studies in order to have the scholarship renewed.
4. Do not submit essays or letters of recommendation from guidance counselors, teachers, or others - these will not be considered. You may include explanation of any special circumstances in the space at the end of this form.
Please note that this form is served across a protected 256 bit SSL (Secure Socket Layer) connection that uses a SHA256 Certificate. It is the industry standard in protection.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
High School*
Guidance Counselor*
GPA (or equivalent benchmark)*

College you plan to attend*
College City and State*
Intended Major*
Total cost of college (tuition, room & board, fees)*
Total amount of financial aid offered to you by your college and other sources*
How much of your financial aid is loans?*
How much of your financial aid is grants or scholarships?*
How much of your financial aid is work study?*
What is your unmet financial need (total cost minus all financial aid)?*
Please enter the amount of your Expected Family Contribution (EFC) from FAFSA*
Please upload your financial aid award letter from your college here*

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Please upload your student aid report issued by FAFSA that includes your Expected Family Contribution (EFC) amount*

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Parent/Guardian #1 Name*
Parent/Guardian #1 Occupation*
Parent/Guardian #1 Address*
Parent/Guardian #2 Name*
Parent/Guardian #2 Occupation*
Parent/Guardian #2 Address*

Please include information on your siblings below*

	Name	Age	At Home Y/N	School or Employer	$ Amount of Scholarships
Sibling 1
Sibling 2
Sibling 3
Sibling 4

Family Financial Information*

	Amount ($)
Monthly mortgage or rent
Parent/Guardian #1 annual income before taxes
Parent/Guardian #2 annual income before taxes
Other family income (dividends, rents, etc)

Student's prior year personal income before taxes*
Student's personal savings*
Please indicate any special or unusual circumstances, financial or otherwise, that you would like the scholarship board to consider.
Should be Empty:

MACK INDUSTRIAL SCHOOL CORPORATION SCHOLARSHIP APPLICATION FOR GRADUATING SALEM GIRLS