College Admissions Form

GERALD "MOE" & MARINA MOSHER VOCATIONAL SCHOLARSHIP
Eligibility Requirements: The Gerald "Moe" & Marina Mosher Vocational Scholarship, established in 2016 as a $2,000 scholarship that will be awarded annually to a graduating senior from a local high school who has been accepted into a post-secondary vocational or technical education program at an accredited institution. Mr. Stewart Appelrouth and Mr. Ed Swift have graciously offered this scholarship in honor or Gerald "Moe" & Marina Mosher, pillars of our local community.

Personal Information
Name*

First NameLast Name
E-mail Address*
example@example.com
Phone*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you a resident of Monroe County?*

YesNo

Educational Information
Upload Transcript*

Cancelof
How many years have you attended Key West High School?

Prospective Post-Secondary Vocation Institution or Technical Program Information

	Program	City/State	Accepted (Yes/No)
1
2
3
4

What is your expected area of study?*
Weighted High School GPA*
Please list any advanced education, vocational, trade, or technical school sources you have taken or are currently enrolled in.

Financial Data
Are you currently employed?*

YesNo

If so, please list job details.

	Company/Business	Job Title	Average Number of Hours Worked per Week
1
2
3
4

Please list the type and amount of any financial assistance you have received or anticipate receiving.
Please explain any family circumstance that may have a financial effect on your plans for college, such as siblings or other family members in college, private tuition, etc.

Community Service

List in order of importance all extracurricular activities, school, religious or community, in which you have participated during high school. You may upload more information if necessary. Do not include employment.

	Activity	Date of Participation	Offices Held
1
2
3
4

Upload information not provided above (optional).

Cancelof
Total number of reported community hours*
List all honors or awards you have received during high school:

First Letter of Recommendation

Cancelof
Second Letter of Recommendation

Cancelof
List the names, addresses and telephone numbers of three individuals (not relatives) who may serve as references. These people should know you and your academic record well. One must be a teach or adminstrator from your high school and a letter of recommendation is required from this person. The other two do not need to provide a letter.

References*

	Name	Address	Phone Number
1
2

Supporting Material
Upload Essay *

Cancelof
On a separate sheet of paper, please state your contribution to the community, your school, civic and religious activities, as well as something about yourself and why you wish to be considered for this scholarship. Include your plans and goals for the future and how you hope to achieve them. This is your chance for our committee to get to know you. (Maximum length of 1 page types and double-spaced.)
Please sign and date this application and agree to attached a certified copy of your high school transcript.

Please note that incomplete applications will not be accepted.
Certified Copy of High School Transcript

Cancelof
Applicant's Signature
Name of Applicant*

First NameLast Name
Date Signed by Applicant*

MonthDayYear
Should be Empty:

GERALD "MOE" & MARINA MOSHER VOCATIONAL SCHOLARSHIP

Personal Information

Educational Information

Financial Data

Community Service

Supporting Material