Keller Masonic Lodge Scholarship Application

Keller Masonic Lodge #1084

Deadline to apply Tuesday, May 10, 2022 by 11:59pm.
2022 Scholarship

The Keller Masonic Lodge #1084 is pleased to announce its 2022 scholarship program. 1(one) $4,000 scholarship will be awarded in accordance with the terms and conditions approved by Keller Masonic Lodge #1084. The scholarships honor graduating high school seniors for scholastic, extracurricular and community efforts and dedication. We highly value students who overcome adversity and hardships in their lives. As an organization we find it important to support those students who face daily challenges and overcome them. All students are encouraged to apply!
Eligibility Requirements

• Be a graduating senior at Keller High School
• Must be a U.S. citizen or a legal resident
• High school transcript must be submitted with this application
• Answers to required questions below (attach writing assignment to this application)
Method of Disbursement

Any proceeds approved and awarded will be disbursed directly to the school of choice. No direct transfer of any fiduciary funds will take place.
Instructions to complete this form

Fill in every blank, if it does not apply type N/A or Not applicable. All fields are required. Submissions without a writing assignment that answers the questions below will be disqualified!
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Current Employer*
Employer
Number of work hours*
How many hours a week do you work outside of school
Employer address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Fathers/Guardian Name*

First NameLast Name
Mothers/Guardian name*

First NameLast Name
Parents/Guardians Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Number*

Area CodePhone Number
Cell Number*
Please enter a valid phone number.
GPA (if available)*
ACT Composite Score (If Available)*
SAT Score (If Available)*
College you plan to attend*
Major*
Have you been accepted to an accredited college or university? Type Yes or No and the college name.*
Have you received or will receive a scholarship(s) that pays for all tuition? Type Yes or No and the amount.*
Have you received any scholarships as of the due date of this application? If so list them and their dollar amounts.*
Are you a first generation college student? (Neither parents nor grandparents attended a college or university)*
Do you have an immediate family member who is a Mason? (If so type their name and lodge information in the blank)*
List any club, organization, or volunteer work you have participated in the last 4 years. List the dates/activities/title and duties.*
List any awards, honors, or recognition you have received in the last 4 years. List the most important. Year/Awards*
Upload your high school transcript
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Writing assignment (Required answers to the following questions) Attach additional sheets if necessary

You will write a paper in a word or pdf. document and attach it to the file upload field below answering the following questions:
1. Have you experienced any hardships in your life?
2. Do you have any masonic ties, do you have any family members who are currently masons?
3. Please go into detail about any volunteer or civil organizations you have assisted?
4. Where do you see yourself in five years? What will be your contribution to society after graduation?
5. Name three people who have influenced your life?
File Upload

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Keller Masonic Lodge #1084

2022 Scholarship

Method of Disbursement

Instructions to complete this form

Upload your high school transcript

Writing assignment (Required answers to the following questions) Attach additional sheets if necessary