Vahan Adjemian Scholarship Application

VAHAN ADJEMIAN SCHOLARSHIP FUND OF TIBREVANK ALUMNI, INC.

ELIGIBILITY REQUIREMENTS
1. An applicant must be of Armenian descent and involved in the Armenian community.
2. An applicant must be in the US and enrolled in a US-based college or university in pursuit of an undergraduate degree only.
3. An applicant must have completed at least 1 semester in a US-based college or university, with transcripts.
4. An applicant must answer all the questions, sign the application form and provide copies of academic transcripts. All transcripts must be official certified transcripts.
5. Previous scholarship recipients are eligible.
6. All applicants will be considered based on service to, or participation in the Armenian community, scholastic achievement and financial need.
You may complete the application online here, or send completed applications and transcripts to:

TIBREVANK ALUMNI, INC.
VAHAN ADJEMIAN SCHOLARSHIP FUND
P.O BOX 14
PALISADES PARK , NJ 07650

ALL APPLICATIONS AND SUPPORTING TRANSCRIPTS MUST BE RECEIVED
NO LATER THAN APRIL 30
SCHOLARSHIP APPLICATION
Personal Information
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Birth Date*

MonthDayYear
Date
Country of Birth*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Academic Information
College/University Attending*
College Level*
For Upcoming School Year
Major/Field of Study*
List Scholastic Honors or Awards Received
Briefly state your plans for continuing your education and what subjects you will pursue*
List any aid or grants that you are receiving*
Armenian Community & School Involvement
Describe your involvement in the Armenian Community.*
Describe your involvement in your School Community.*
How do you plan to give back to the Armenian community?*
Parent Information
Father's Name*

First NameLast Name
Father's Address

Same As Applicant
Father's Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Father's Phone Number*
Please enter a valid phone number.
Father's Occupation*
Mother's Name*

First NameLast Name
Mother's Address

Same as Applicant
Mother's Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Mother's Phone Number*
Please enter a valid phone number.
Mother's Occupation*
References

NAME TWO PERSONS, OTHER THAN RELATIVES, AS CHARACTER REFERENCES
Reference 1 Name*

First NameLast Name
Reference 1 Address*

Street Address

Street Address Line 2

CityState

Zip Code
Reference 1 Phone Number*
Please enter a valid phone number.
Reference 1 Email*
example@example.com
Reference 2 Name*

First NameLast Name
Reference 2 Address*

Street Address

Street Address Line 2

CityState

Zip Code
Reference 2 Phone Number*
Please enter a valid phone number.
Reference 2 Email*
example@example.com
Statement
PLEASE STATE YOUR FUTURE EDUCATIONAL PLANS, YOUR CAREER AMBITIONS AND FINANCIAL REASONS FOR YOUR REQUEST *
I HEREBY SUBMIT MY APPLICATION FOR VAHAN ADJEMIAN SCHOLARSHIP FUND OF TIBREVANK ALUMNI, INC. IN SO DOING I ATTEST TO THE VERACITY OF THE INFORMATION PROVIDED, INCLUDING OFFICAL COPIES OF MY COLLEGE/UNIVERSITY TRANSCRIPTS. FURTHERMORE, I UNDERSTAND THAT BEFORE ANY AWARD CAN BE MADE I MUST FIRST APPLY TO AND BE ACCEPTED AT A RECOGNIZED UNIVERSITY OR COLLEGE, REGISTERED AND COMPLETE AT LEAST A COURSE LOAD REQUIRED TO RETAIN STANDING AS A FULL-TIME. I ALSO UNDERSTAND THAT THE AWARD WILL BE MADE FOR (1) ONE ACADEMIC YEAR.
Signature of Applicant*

Clear
Date*

MonthDayYear
Date
Official Academic Transcript*

APPLICANT PLEASE NOTE:YOUR SCHOLASTIC TRANSCRIPTS MUST BE OFFICIAL (CERTIFIED) TRANSCRIPTS
Cancelof
Photograph*

A SMALL PHOTOGRAPH OF YOURSELF MUST BE SUBMITTED TOGETHER WITH THIS APPLICATION FORM
Cancelof
Should be Empty:

SCHOLARSHIP APPLICATION

Personal Information

Academic Information

Armenian Community & School Involvement

Parent Information

References

Statement