RBH High School Registration

RBH High School Scholarship Application

Fill out the form carefully for registration
Student Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail*
example@example.com
Name of High School Attending*
Expected High School Graduation Date*
Name of College or University you expect to attend*
College or University Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
College Or University Degree/Certificate to be conferred*
College or University Major Course of Study*
Year of Graduation*
Applicant Eligibility Criteria:

Applicant must provide the name of your descendants family member and the decade they attended Richard Berry Harrison High School
Descendants Name*

First NameMiddle NameLast Name
Decade attended*
Additional Comments
Should be Empty:

RBH High School Scholarship Application