NC NAPUS CHAPTER SCHOLARSHIP
APPLICATION
FULL NAME
HOME ADDRESS
DATE OF BIRTH HOME PHONE
NUMBER
HIGH SCHOOL NAME AND ADDRESS
NAME OF PRINCIPAL DATE
OF GRADUATION
Number of Students in your High School class Your rank in High School class
High School Grade Point Average Based on a 4.0 or 5.0 scale (Please circle) ACT
Score
College name, city & state (if attending now)
Full name, work location (city,
zip code) and relationship of your NAPUS member sponsor
Name and address of two or four
year college or vocational college you plan to attend:
Have you applied for admission?
Has your application been approved?
Do you currently work? If yes,
where or for whom?
Average hours worked per week Do you plan to work while attending college? •
THE FOLLOWING ITEMS MUST BE INCLUDED WITH THIS COMPLETED
APPLICATION
1-OFFICIAL HIGH
SCHOOL TRANSCRIPT AND CURRENT COLLEGE TRANSCRIPT (IF APPLICABLE). 2-COPY OF ACT AND/OR SAT SCORE.
3-TWO, CHARACTER
REFERENCE LETTERS WRIT I EN BY A NON-RELATIVE. 4-COPY OF LETTER OF ACCEPTANCE FROM THE COLLEGE
OF CHOICE.
5-A
TYPED SUMMARY OF YOUR HIGH SCHOOL, COLLEGE, AND COMMUNITY ACTIVITIES, AWARDS AND HOBBIES. List by name and
year Membership
and other Participation and approximate time commitment
for each school, community and volunteer activities. Example: Yearbook Staff
(10,11, college) 25 hrs. per month for 6 months / basketball (9,10,11,12,
college)
40 hrs per month for 3 months.
List by name and year Leadership Positions and Offices held, and approximate time commitment for each of school, community and volunteer activities. Example: Student Council Representative
(9,10,11,12) 12 hrs. per month for 5 months / 4-H Leader (11,12, college) 5
hrs. per month for 4 months.
List by name and
year the Honors
and/or Awards you have received. Example: All Conference Basketball (11,
college) / Boys/Girls
State (11) / Jr. Rotarian (10).
List any Volunteer Work Positions you have had. Example: Candy
Striper (11,12, college) 20 hrs per month for 3 months / Farm helper (11,12,
college) 24 hrs. per month for 4 mos.
List any Paid
Work Positions you have had. Example: Grocery Store (11,12, college) 16
hrs per month for 2 months / Cafe work (10,11,12, college) 20 hrs per month for
4 months.
6 -YOUR
RESPONSE TO THE QUESTION; "WHAT ARE YOUR CAREER GOALS AND HOW WOULD THIS
SCHOLARSHIP
HELP YOU TO ATTAIN THEM?"
Randy Mabry
Polkton, NC 28135
1634 W. Park Ave.
Albemarle NC 28001