PADDY DAMSCHEN MEMORIAL SCHOLARSHIP FUND

2012 Scholarship Application

APPLICATIONS DUE BY 5PM ON APRIL 30, 2012

APPLICANT INFORMATION
Last Name Street Address City Phone Legal Guardians Name (if under 18): Are you a citizen of the United States? Have you ever been convicted of a crime? YES YES NO NO If yes, explain State E-mail Address First M.I. Date

Apartment/Unit # ZIP

EDUCATION

High School Date of Graduation:

Address

Grade Point Average (GPA) based on 4.0 scale:

Attach proof of GPA

I WILL BE ATTENDING THE FOLLOWING MONTANA SCHOOL IN THE FALL OF 2012 College Anticipated Major: List any college courses you have already taken:
College: Course: College: Course: College: Course: Address Dates: Address: Dates: Address: Dates:

Proof of acceptance or current student enrollment from the school listed below, in writing, required by August 15, 2012

Address

Grade:

Grade:

Grade:

FINANCIAL INFORMATION
This information will be kept confidential and is only used for determining need of financial assistance.
Annual Household Income (pre-tax): Other scholarships or financial aid received: Relationship to Applicant Phone ( )

PADDY DAMSCHEN MEMORIAL SCHOLARSHIP FUND

2012 Scholarship Application

Institution or Organization awarding aid: Amount: Institution or Organization awarding aid: Amount: Institution or Organization awarding aid: Time Period: Time Period

OTHER INFORMATION
Number of years in Track & Field: Number of years Varsity:

List any volunteer/community services or extra-curricular activities you have been involved with over the last 2 years:

List any academic honors, memberships, or other honors:

ESSAY
Essay must be typed and can be attached to this application. At least 200 words and no more than 300 words.

PADDY DAMSCHEN MEMORIAL SCHOLARSHIP FUND

2012 Scholarship Application

How has sports affected your life? What lessons will you take from your participation in sports and use in the rest of your life?

PADDY DAMSCHEN MEMORIAL SCHOLARSHIP FUND

2012 Scholarship Application

LETTER OF RECOMMENDATION

Please provide one (1) letter of recommendation from either your head track coach, or your head events coach. This letter should include information about your commitment to your athletics, academics, and the community. Letter can be no more than 2 pages, typed, and must have an original signature.

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application leads to a financial award, I understand that false or misleading information in my application will result in loss of the award. Signature Date

APPLICATIONS DUE BY 5PM ON APRIL 30, 2012

Send application: Paddy Damschen Memorial Scholarship Fund 825 Onyx Place Helena, MT 59602 Or via email: cjdamschen@hotmail.com

OTHER IMPORTANT DATES AND INFORMATION Winners will be contacted by May 31st. Award winners will be recognized at their respective Track Awards Banquets in June. Payment will be made directly to the college or technical school, payments will not be made directly to individuals. Payments will be made by August 31, 2012.

For Internal Use Only

Date Received: __________ Complete: ___ Yes ___ No RD: ____ Total Score: ____________ TD: ____ FK: ____ CK: ___