Tom Fisher Foundation Scholarship Application Form

Tom Fisher Foundation Scholarship Application Form
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

High School Name*
High School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Counselor’s Name and Email Address*
Expected Graduation Date*

MonthDayYear
Date
Cumulative GPA*
Why are you applying for this scholarship?*
Essay (250-500 words)

List your extracurricular activities, including sports, clubs, and organizations:*

Rows	Name	Position/Role	Duration
Activity 1
Activity 2
Activity 3

List your community service activities and volunteer work*

Rows	Organization	Position/Role	Duration
Activity 1
Activity 2

List any awards or honors you have received*

Rows	Name	Description	Date
Award 1
Award 2

Parent/Guardian Name*

First NameLast Name
Parent/Guardian Occupation*
Education and Career Plans*

I plan to attend a technical or trade schoolI plan to attend a two year college/community collegeI plan to attend a four year college/universityI plan to pursue apprenticeship or certification in a tradeUndecided, but exploring career paths in skilled trades or technology

Academic Reference*

Rows	Name	Position	Contact Information
Reference

Personal Reference*

Rows	Name	Position	Contact Information
Reference

Applicant's Declaration

I hereby declare that the information provided in this application is true and accurate to the best of my knowledge. I understand that any false information may result in the disqualification of my application.
Applicant's Signature*
Date signed*

MonthDayYear
Date
Should be Empty: