Daniel E. Bolinger Memorial Scholarship

This scholarship is available to a graduating senior from Whitko High School and who is interested in obtaining an associates degree from a junior college or vocational school.

Scholarship Application Deadlines

Application due April 15

Instructions

You will not be able to save this application or come back to it later. If you close out your browser, you will need to start your application over.

Please review this form and have your responses ready. It is advised to prepare your answers in advance. You may also copy and paste your answers from Microsoft Word or other text based programs.

Applicant Information

Name*

Address*

City State Zip*

Tell us something interesting about you.*

Upload a picture of yourself.*

Date of Birth*

Telephone Number*

Email*

Re-enter email*

Family Information

Please choose whom you are living with.

Name

Address

Place of Employment/Occupations

Education

Please choose whom you are living with.

Name

Address

Place of Employment/Occupation

Education

Number of siblings and their ages

Extracurricular Activities

Please list any clubs, teams or groups (school, church, community, & etc.) you have been involved in and the years you have actively participated in the program.

Work Experience

In the space provided below, please provide employment history:

College or University Information

Please list the vocational or junior college you plan to attend

What do you plan to study?*

Transcript

Please provide a copy of your current high school transcript*

Certification

I hereby affirm that the information provided in this application is accurate and complete to the best of my knowledge.*

Security

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