Scholarship & Incentive Awards

Application

Applications must be typed or neatly printed in black ink and completely filled out. Date:

NAME:
Last First M.I. Male/Female

ADDRESS:
City: State: Zip:

PHONE: CELL:

EMAIL:

PARENT(S)/GUARDIAN NAME:
WHAT FAMILY BRANCH ARE YOU?
Check [  ] one:
Brown _____ Chisholm _____ Mitchell ____ Scott ____

--Academic Record--

HIGH SCHOOL: TELEPHONE:

ADDRESS:
Street City State Zip

GRADE POINT AVERAGE: RANK IN CLASS:

LIST COLLEGE/UNIVERSITY ACCEPTANCES: COLLEGE YOU PLAN TO ATTEND:

1.
2.
3. ANTICIPATED MAJOR:
COMMUNITY ACTIVITIES: SCHOOL ACTIVITIES:
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.

List any awards /recognition / publicity you have received for your academics, athletics and/or
community service achievement:
1.
2.
3.
4.
5.

Please include the following information to your application by July 10, 2009:
A. Completed Application
B. Official Transcript
C. Essay (one-page, typed and double spaced, stating why you are deserving of the Family Scholarship)
D. Proof of College Acceptance
Mail Completed Application Packets to: BCMS Family Reunion , c/o Scholarship Selection Committee,
14625 Baltimore Avenue, #137, Laurel, MD 20707
Selection of recipient(s) will be made on the night of Family Banquet – July 25, 2009