Douglas Anderson High School No. 107 Alumni Association Inc.

Nathaniel S. Washington Scholarship for Community Service - 2024

SCHOLARSHIP APPLICATION

Date:______________________________________

Personal Data
Name: __________________________________ _________________________ ____________________________

Date of Birth: _____________________________ Phone Numbers: ______________________ ________________

Home Cell
Current Residence: ________________________________ _______________________________ _________________
Street City Zip

Name(s) of Parent(s) or Guardian: ______________________________________________________________________

Number of Siblings who reside in household ____________ Brothers _______________ Sisters ___________________

Education Data
School presently attending:
__________________________________________________________________________________________________

School Address: ______________________________ _______________________ _________________ ____________

Street City State Zip

Grade Point Average (Grades 9 through first semester of senior year).

Transcripts must accompany the scholarship application.
_________________ _________________
Weighted Unweighted

SAT Scores: ______________________ _____________ ACT Composite Score: _____________

Verbal Math
Address: ________________________________________ _____________________ __________________ _________
Street City State Zip

College, University or Seminary you plan to attend: ________________________________________________________

__________________________________________________________________________________________________

Address: _____________________________________________ _____________________ ___________ __________

Street City State Zip

You must show proof of acceptance before scholarship is awarded

Nathaniel S. Washington Scholarship for Community Service 1

Community Service
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

Church Activities/Club and Organization Information

Please complete each section. Do not be Modest! All information can be used by the
scholarship committee during the selection process. (attach additional sheets if needed)

Activity/Club/Organization Leadership Position Held

__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

Relative
Please give the name, year and your relationship to a relative that graduated from Douglas
Anderson High School No. 107 prior to 1969.
__________________________________________________________________________________________________
__________________________________________________________________________________________________

References
Three letters of references are required. One must come from a Teacher, one from a
Counselor and one from a church Members or a Neighbor or an Employer. References from
relatives will not be considered. Letters of reference should address the following.

Character • Personality • Motivation • Initiative • Sense of responsibility • Citizenship

Educational Goals: Write a letter which clearly and completely details your future plans.
Letter must be included with the application.

Deadline for application and letters of references: May 1, 2024

Note: Applications received after the deadline will be disqualified.

Direct application and letters of reference to:

Douglas Anderson No. 107 Alumni Association, Inc.
Attention: Mrs. Constance M. House, Scholarship Chairman
Post Office Box 5583
Jacksonville, Florida 32247-5583
Updated
03/18/2024 fdc

Nathaniel S. Washington Scholarship for Community Service 2