The Albert O. Miller, Dorothy Tozer Miller, and Savona Commandery #89 Scholarship

The Albert O. Miller, Dorothy Tozer Miller, and Savona Commandery #89 Scholarship
Applicant Information
Completed application with all attachments must be received by Friday, April 10, 2026. Please see instructions.
Check here if you have received this award in the past
Name

First NameMiddle InitialLast Name
Sex

FM
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone
Email Address
example@example.com
Social Security Number
Date of Birth

MonthDayYear
Total number of members in your household
Total number of those who will be in post-secondary schools next year
High School Information
Name of your High School
Graduation Date

MonthDayYear
GPA
You must attach copies of your last two (2) years grades a copy of transcript or report cards.
Post-Secondary School Information
Name of Post-Secondary School You Plan to Attend
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone
Email Address
example@example.com
Year in School next Year
Major
Degree Sought:
2- or 4-year school?
Expected Graduation:

MonthDayYear
You will: Live on campus:
Live off campus:
Commute from home:
If already attending, you must attach copies of your transcript for all time attended.
Parent-Guardian Information
Name

First NameMiddle InitialLast Name
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone
Email Address
example@example.com
Relationship to Applicant
Attach copy of most recent FASFA.
Education Expenses & Contribution for Next Year
Untitled Matrix
Untitled Matrix
List scholarships and grants (not loans) you expect to receive for next year:
More Information About You
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?
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 below:
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.

More Information About You (Continued)
Please describe how any unusual family or personal circumstances have affected your achievement in school or participation in activities: Must be 500 words or less.

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	Occupation	Address	Phone #
1
2
3

Certification
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 retumed. 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

Clear
Date

MonthDayYear
Date
Signature of Parent or Guardian

Clear
Date

MonthDayYear
Date
3

Instructions
- Complete all sections and information.
- Include all requested attachments. Pay close attention to all necessary attachments under each section.
- Incomplete applications or those with missing information will not be considered.
- Return two [2] copies of the entire application and all attachments in a sealed envelop marked "Miller Scholarship Application, Attn: Trust Department" to any office of The Honesdale National Bank no later than 4PM on Friday, April 10, 2026.
- If you are unable to deliver the application package during business hours, you may mail the package to:
Miller Scholarship Application
Attn: Trust Department
The Honesdale National Bank
724 Main Street
PO Box 350
Honesdale, PA 18431
- Be sure to mail early to allow delivery by the deadline.
- Award decisions will be made by Friday, May 8, 2026.
- Award recipients will be notified shortly thereafter.
Information and Award Criteria
The ALBERT O. MILLER, DOROTHY TOZER MILLER, AND SAVONA COMMANDERY #89 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 Savana Commandery #89, Honesdale, PA. All decisions of the Committee shall be final.
- Correspondence to the committee should be sent to:
Miller Scholarship Application
Attn: Trust Department
The Honesdale National Bank
724 Main Street
PO Box 350
Honesdale, PA 18431
- In 2026, the Committee will award at least one (1) $1000.00 scholarship as follows:
  - One (1) renewable scholarship to a 2026 high school graduate
- If a second award can be made it will be in this category:
  - One (1) one-time scholarship to a 2026 high school graduate OR a student who graduated high school prior to 2026
Should be Empty:

The Albert O. Miller, Dorothy Tozer Miller, and Savona Commandery #89 Scholarship

Applicant Information

High School Information

Post-Secondary School Information

Parent-Guardian Information

Education Expenses & Contribution for Next Year

More Information About You

More Information About You (Continued)

Certification

Instructions

Information and Award Criteria