Miller Scholarship Fund Application 2025

Completed application with all attachments must be received by Friday, April 11, 2025. Please see instructions.

The Albert O. Miller, Dorothy Tozer Miller, and Savanna Commandery #80 Scholarship Fund was established by the Last Will and Testament of Dorothy Tozer Miller. The Millers understood and advocated the primary Masonic ideals of education, worship and charity. To that end, the Scholarship Fund was established to promote intellectual enlightenment among the youth of Wayne County, Pennsylvania.

Primary recipients are awarded one thousand dollar ($1000.00) annual scholarships which are renewable up to four (4) additional years (possible total award of $5000.00). The award will be paid jointly to the recipient and his/her chosen institution of higher learning. The annual award will be paid in two (2) equal installments, one (1) prior to the start of each semester.
If funding permits, additional one-time awards may be made. The award will be paid jointly to the recipient and his/her chosen institution of higher learning. The award will be paid in two (2) equal installments, one (1) prior to the start of each semester.
Only those potential recipients anticipating attending or actually attending four (4) year colleges and universities in pursuit of a bachelor’s degree or equivalent may receive an award.
Award recipients must have completed high school with at least the equivalent of a 2.5 GPA based on a 4.0 GPA scale. Recipients must also, while in college, attain an accumulated GPA of 2.5 out of 4.0 GPA for his/her first and second semester and a GPA of at least 3.0 GPA out of 4.0 GPA (or equivalent) in each subsequent semester.
All award recipients must be full-time students taking at least twelve (12) credit hours per semester.
All recipients must provide the Scholarship Committee (see below) with a copy of his/her grades at the end of each semester in order to be considered for continuation of a renewable award or for future consideration of “one-time” awards.
Award decisions will be based on the showing of need and the information contained in and attached to the application. Neatness and cogent thought will be considered. All recipients must be of good moral character and of good report within his/her community and school.
Masonic affiliation is useful but not required or solely determinative of award.
Wayne County, Pennsylvania, residency is highly considered in the award. Residency outside Wayne County does not automatically disqualify an applicant. Because of the number of highly qualified Wayne County applicants in the past, the committee advises that it is unlikely that an applicant from outside the county will be successful in obtaining an award.
Award decisions will be made by a Scholarship Committee consisting of five (5) Knights Templar of Savona Commandery #89, Honesdale, PA. All decisions of the Committee shall be final.
In 2025, the Committee will award at least one (1) $1000.00 scholarship as follows: One (1) renewable scholarship to a 2025 high school graduate. If a second award can be made it will be in this category: One (1) one-time scholarship to a 2025 high school graduate OR a student who graduated high school prior to 2025.

Have you received this award in the past?*

YesNo

Name*

First NameMiddle NameLast NameSuffix

Sex*

FemaleMale

Date of Birth*

Date

Address*

Street Address

CityState

Zip Code

Email*

Phone Number*

Area CodePhone Number

Social Security Number*

Total Number of Members in Your Household*

Total Number of Those Who Will Be in Post-Secondary Schools Next Year*

Name of High School*

Graduation Date*

Date

Attach copies of your last two (2) years grades (a copy of transcript or report cards)*

Name of Post-Secondary School You Plan to Attend*

Address*

Street Address

CityState

Zip Code

Email*

Phone Number*

Area CodePhone Number

Year in School Next Year*

Major*

Degree Sought*

Expected Graduation Date*

Date

2- or 4-Year School*

2-Year School4-Year School

Where will you reside during your post-secondary education?*

Live on CampusLive Off CampusCommute from Home

If already attending, attach copies of your transcript for all time attended

Name*

First NameMiddle NameLast NameSuffix

Address*

Street Address

CityState

Zip Code

Email*

Phone Number*

Area CodePhone Number

Relationship to Applicant*

Attach copy of most recent FAFSA

Tuition & Fees

Transportation

Room & Board

Books & Supplies

Other Expenses

Total Education Expenses

Savings & Investments

Summer Job

School Year Job

Parents/Guardians

Other Income

Total Income Expected

List scholarships and grants (not loans) you expect to receive for next year and their amounts

Are you a child, stepchild, grandchild, sibling or dependent (IRS definition) of a member in good standing of a Masonic Lodge (or who was in good standing at the time of his death), or a present or former member in good standing of a Masonic-related youth group?*

YesNo

If yes, provide details of member name, relationship, body name and location

List your activities, awards, and honors during the past four (4) years*

In paragraph form, please state your primary lifetime goals and how your intended education will help achieve said goals (must be less than 500 words)*

Please describe how any unusual family or personal circumstances have affected your achievement in school or participation in activities (must be less than 500 words)*

Please provide identifying information for three (3) personal references. We recommend, but do not require, that one (1) be an educator and one (1) a member of the clergy.

Name*

First NameLast Name

Occupation*

Address*

Street Address

CityState

Zip Code

Email*

Phone Number*

Area CodePhone Number

Name*

First NameLast Name

Occupation*

Address*

Street Address

CityState

Zip Code

Email*

Phone Number*

Area CodePhone Number

Name*

First NameLast Name

Occupation*

Address*

Street Address

CityState

Zip Code

Email*

Phone Number*

Area CodePhone Number

I hereby certify that all information contained herein, or attached, is true and correct to the best of my knowledge. I understand that this application and attachments cannot be returned. I also hereby authorize any person, authority, school or other institution to release any and all requested information to the Scholarship Committee which may be useful or otherwise have a bearing on their ability to make a determination of award. I understand the name(s) of the award recipient may be published in area newspapers and the recipient(s) may be asked to provide a photograph.

Signature of Applicant*

Signature of Parent/Guardian*

Date*

Date

Date*

Date

The Albert O. Miller, Dorothy Tozer Miller, and Savanna Commandery #80 Scholarship Fund Application

Information and Award Criteria

Completed application with all attachments must be received by Friday, April 11, 2025. Please see instructions.

Applicant Information

High School Information

Post-Secondary School Information

Parent Guardian Information

Education Expenses & Contribution for Next Year

Education Expenses (Per Year)

Amount Expected From

Scholarships & Grants

More Information About You

Personal References

Reference #1

Reference #2

Reference #3

Certification