EmailMe Form - Shinglehouse Volunteer Ambulance Association

A $500.00 and a $300.00 scholarship will be awarded each year to two (2) deserving students who display the following qualities:
A. Good Citizenship (Character, Leadership, Service)
B. An interest and desire to further their education
C. Completed and submitted scholarship application by May 1st. Application must contain their reason for applying.

*An alternate for each scholarship will be chosen and they will receive a cash award of $50.00 each.*
*A special award of $100.00 will go to a student pursuing an education in the medical field.*

Application

Name

First Last

Date

MM / DD / YYYY

Age

Class Rank

Phone

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Student Email

Parent/Guardian Name

First Last

College/University/Trade/Business School Name

Address

Field of Endeavor

Please explain, briefly, the reason (s) you are applying for the scholarship.

*Financial need will be considered when applications are reviewed.*