SCHOLARSHIP APPLICATION

       ROBERT V. PIRRIE MEMORIAL SCHOLARSHIP

APPLICATION FOR ROBERT V. PIRRIE MEMORIAL SCHOLARSHIP
($1,500.00 non-renewable)

 

Section I. Information to be supplied by applicant:       (ALL INFORMATION REQUIRED)
       
By submitting this information, I agree to provide true, accurate, current and complete information about yourself as requested.
I also agree to notify MSPS and update the information about myself promptly as necessary to keep it current and accurate.
       
Name in Full:
  First Name
  Full Middle Name
 Last Name
       
Date of Birth:
  mm/dd/yy		 Male   Female  
Birthplace:
  City
  State		  
Phone:   Email:   
       
       
Full Name of Guardian:
  First Name
  Full Middle Name
 Last Name
  Address:  City:  
  State:  Zip:   
  Phone:  Email: 
   
   
Father's Occupation:
Mother's Occupation:
       
Number of bothers and sisters older than you:    
Number of bothers and sisters younger than you:    
       
In the space below, briefly summarize your school, church and community activities. List organizations of which you are a member and offices held:
       
Reason why it is necessary for applicant to receive a scholarship?
       
How will this scholarship help you attain your future goals?
       
What college or university do you plan to attend and its location?
       
What courses?
       
Date you expect to enter:   (mm/yy)    
Degree you are working toward:
       
Please list all other scholarships, awards or financial aids for which you have applied, or have been granted (indicate which) for the coming school years.
Name of FInancial Aid
Value
Has it been granted to you?
Yes      No
Yes      No
Yes      No
Yes      No
Yes      No
Yes      No
       
Indicate what you have done in planning ahead to help meet your anticipated college expenses. How have you earned or saved money, and what will be your plans for the coming summer?
       
The Applicant herewith consents that the Scholarship Selection Committee is fully informed as to the Applicant's scholastic standing, character, and other factors having a bearing on this Application. The Applicant also agrees to enroll in Scholarship Selection Committee approved surveying related courses in pursuit of a land surveying profession.
       

  Guardian's Full Name
  Applicant's Full Name
 
Enter Anti-Spam Code:    
   
       
       

IMPORTANT: AFTER YOU HAVE COMPLETED YOUR PORTION OF THIS APPLICATION, PROVIDE YOUR PRINCIPAL OR COUNSELOR THE FOLLOWING LINK FOR FOR HIS/HER CERTIFICATION:

WWW.MISSOURISURVEYOR.ORG/RVP
PRESS SUBMIT ONLY ONCE
    

 
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