Name (last, first,
middle):______________________________________________________________
Applicant's Student
Number: ___________________________________________________________
Sex M______ F_______
Date of Birth: _____________________________________________
Place of Birth:
_____________________________________________
Applicant's Relationship to the Post 91 Sponsor:
Sponsor's Name:
___________________________________________________________________
Sponsor's Post 91 Member
Number: _______________________________________________________
Sponsor's Current Post 91
membership type and status: Life:____ Annual Dues _____ Current Y: ___ N: ___
Home Mailing Address and Telephone Numbers (this is where
mail to you will be sent if you do not list a permanent address)
Number and Street:
__________________________________________________________________
City State Zip:
_______________________________________________________________________
Home Telephone Number:
(    ) ____ -_____
Work Telephone Number:
(    ) ____ -_____
Permanent Address and Telephone Numbers (if different from
above)
Number and Street:
__________________________________________________________________
City State Zip:
_______________________________________________________________________
Home Telephone Number:
(    ) ____ - _____
Sponsor's Address and Telephone Numbers (if different from
home address)
Number and Street:
__________________________________________________________________
City State Zip:
_______________________________________________________________________
Home Telephone Number:
(     ) ____-_____
Work Telephone Number:
(     ) ____ -_____
Are you enrolled in
college ROTC? (Please check one) Yes: _____ No: _____
If not, do you intend to
enroll in college ROTC? (Please check one) Yes: ____ No: ____
Statement of Certification (both signatures are required)
I certify that the
information provided in this application is accurate and complete to the best
of my knowledge. I understand that failure to provide full documentation or
falsification of credentials will result in disqualification of this
application. I agree to provide, if requested, official documentation to verify
information reported on this application. In the event that I receive a
scholarship award and elect not to attend school during the year, I will
immediately return the award to Post 91. I also understand that the decision of
the Post 91 Scholarship Committee is final.
Applicants Signature: _________________________________________________________
Date: ____________________
Sponsor's Signature: _________________________________________________________
Date: _____________________
| 
Provide
  copies of SAT/ACT scoresheets, report cards/transcripts of all high
  school/university courses indicating all courses taken and grades earned.
  Also provide documentation of Class Standing if not on transcript (See
  Instructions) | ||||
| 
List
  the High Schools, Universities, Colleges and Technical Schools you have
  previously attended: (list all schools) | ||||
| 
Institution
  Name | 
City | 
State | 
Month/Year | 
Degree
  Award/Year | 
|  |  |  |  |  | 
|  |  |  |  |  | 
|  |  |  |  |  | 
|  |  |  |  |  | 
| 
List
  current or future accredited Post-Secondary Schools (technical or college) to
  which you have applied, been accepted or are currently attending. | |||
| 
Institution
  Name | 
Attending | 
Applied | 
Accepted | 
|  |  |  |  | 
|  |  |  |  | 
|  |  |  |  | 
| 
Grade
  You Will Be Attending Next Fall. (please check one) |  | 
Freshman |  | 
Sophomore |  | 
Junior |  | 
Senior | 
| 
List
  school clubs and organizations to which you belonged) to include positions
  held, dates, honors/awards. (include any civic, scholastic
  honors/distinctions received) | 
|  | 
|  | 
|  | 
|  | 
|  | 
| 
List
  volunteer/community/church activities to include positions held, dates and
  honors/awards. | 
|  | 
|  | 
|  | 
|  | 
| 
List
  leadership positions held to include honors/awards. | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
| 
List
  athletic participation in organized sports or similar activities to include
  positions held, dates, honors/awards. | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
| 
List
  any employment during each year of high school/university/college attendance
  to include summer jobs. | |||
| 
Month/Year | 
Employer | 
Position | 
Hours
  Per Week | 
|  |  |  |  | 
|  |  |  |  | 
|  |  |  |  | 
|  |  |  |  | 
| 
List
  any additional information you feel is pertinent to this application. (e.g.
  home schooling, child rearing, homemaking, etc) | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
|  | 
| 
Have
  you ever been convicted of any charges other than minor traffic violations? |  | 
Yes |  | 
No | 
If
  Yes, Please explain below. | 
|  | |||||
|  | |||||
|  | |||||
|  | |||||
|  | |||||
| 
Scholarship
  Essay Question (your essay maybe typed or handwritten and should not exceed
  300 words) (attach your essay after this page of the application) | 
| 
If
  you could change one thing in the United States today, what would it be and
  how might you accomplish this change? | 
| 
FINAL CHECKLIST | ||
| 
Item | 
Yes | 
NO | 
| 
Statement of Certification |  |  | 
| 
Attach School Transcripts |  |  | 
| 
Attach Grade Point Average |  |  | 
| 
Class Ranking Documentation |  |  | 
| 
Attach SAT/ACT Scores |  |  | 
| 
Schools, Clubs and Activities |  |  | 
| 
Volunteer/Community/Church Activities |  |  | 
| 
Leadership Positions |  |  | 
| 
Athletic Participation |  |  | 
| 
Outside Employment |  |  | 
| 
Attach Essay |  |  | 
| 
Include Current Photo |  |  | 
 

