SCHOLARSHIP APPLICATION

CATALINA MOUNTAIN ELKS LODGE NO. 2815
PAST EXALTED RULERS' ASSOCIATION SCHOLARSHIP


ELIGIBILITY:  Applicant must be a United States citizen, whose primary residence is in the greater northern metropolitan area of Tucson.  Applicant must have successfully completed one grading period of study in a United States post-secondary educational institution of learning;  be enrolled in a United States post-secondary educational institution of learning;  and pursuing an undergraduate or graduate degree or pursuing post-secondary vocational/technical certification in a vocational institution or college.
This scholarship is awarded only once to the same student and is disbursed only for the second term of the student's school year.

All sections must be completed and required documents filed with the application. (Please print or type, where applicable.)

Applicant's Name (in full): __________________________________________________________ 

____________________________________________, _________________, _________________
                             Street Address                                                                                        State                                    Zip Code              

______________________, _____________________, ___________________________________
             Home Phone #                                      Cell Phone #                                                                e-mail address

Name of Educational School enrolled: _________________________________________________ 

Major Field of Study: _______________________________________________________________

Degree Objective: (circle one):  Associate	Bachelor's	 Graduate	Certificate

Anticipated date of completion: _______________________________________________________

Full time student (circle one):          Yes               No

Documents to be filed with application:
1)	Applicant's Statement (achievements, community service)
2)	Letter from an individual (relative or friend) summarizing applicants background and character
3)	Letter of endorsement/recommendation from a person not related to applicant
4)	Letter from a current or former educator
5)	Official transcript from the United States post-secondary educational or post-secondary vocational/technical institution in which the applicant is enrolled (Minimum of one grading period successful completion is required)
6)	Verification of citizenship status

This application, and appropriate documents, must be received by Catalina Mountain Elks Lodge #2815, C/O P.E.R. Association Scholarship Program,  16045 N. Oracle Road, P.O. Box 8742, Tucson, AZ  85738 on, or before March 1 of the calendar year in which the monies are requested.



______________________________________________________
Applicant's Signature
Rev A, 4/10/2010