Information and Guidelines for Scholarship Applications

The Dallas Scottish Rite Library and Museum, Inc. (Hereinafter Foundation) is a Masonic Program and is an
appendent body to the Dallas Scottish Rite Bodies, a Masonic fraternity. The Trustees for the Foundation manage a
Charitable Trust, the corpus of which generates funds that are used by the Trustees to fund charitable endeavors such
as, a Literacy Program, contributions to the Texas Scottish Rite Hospital for Children, and a graduating high school
seniors college scholarship program offering merit-based scholarships to deserving high school graduates. The
number of scholarships awarded each year is a function of the Trust. These scholarships will be awarded without
regard to sex, race, color, creed, national origin or religion.
The following guidelines are offered to assist student applicants and high school counselors:

1.

The scholarship competition is open to graduating high school seniors of the current school year
from all schools in the 40 counties of Texas, which are part of the Dallas Scottish Rite
membership area. It IS NOT necessary for the applicant or their family to have ties to the Masonic
organization.

2.

Scholarship value is $1,000.

3.

Every application or submittal is reviewed and graded on a merit/student achievement basis.

4.

SAT (or ACT) scores and high school transcripts will be used to determine the academic merit.
High school transcripts will be used to determine class ranking and grade point average.

5.

Academic references should be from the faculty of the school attended by the student.

6.

Personal and academic recommendations must cite specific achievements and activities, as
applicable, to the student being recommended.

7.

The student should be careful to comply with the Instructions for Application Submittal. The
deadline for submittal of applications is January 31, 2014.

8.

In order to give considerations to all the school districts in the Dallas Scottish Rite area (40
counties), no more than two scholarships will be awarded to any one individual high school
graduation class.

9.

Follow instructions accurately. Answer all questions on the application. Assemble application in
numerical sequence.

10.

Sequence for application

a.
b.
c.
d.

Attach full transcripts from most recent school.

Attach copy of SAT or ACT scores if taken.
Attach two or more personal reference letters.
Attach two or more academic reference letters.

Scholarship Application
Dallas Scottish Rite Library and Museum
Application Deadline: January 31 2014 - Term: Fall 2014 Spring 2015
To: 500 South Harwood Dallas, Texas 75201
A MASONIC PROGRAM

NOTE: EARLY APPLICATIONS ARE APPRECIATED!

APPLICATIONS MUST BE POSTMARKED OR HAND DELIVERED
BY JANUARY 31, 2014. APPLICATIONS POSTMARKED AFTER
JANUARY 31, 2014 WILL NOT BE CONSIDERED

Please complete the attached worksheet for Clubs, Activities, and Organizations
PLEASE PRINT OR TYPE:
Name: _______________________________________________________________________________________
(First Name)
(Middle Name)
(Last Name)
Address: __________________________________ City: _______________ State: _______ Zip: ___________
Permanent Address:_____________________________________________________________________________
E-Mail Address:_____________________________________________________________________________
Age: ________

Date of Birth: ______________________ Place of Birth: ______________________________

Home Telephone No. ___________________________

Cell Telephone No. _________________________

College or University to attend: ___________________________________________________________________

Address of College or University: _________________________________________________________________
_____________________________________________________________________________________________
Graduating High School, City ____________________________________________________________________
Date to Graduate from High School: ________________________________Male __________Female__________
Employment Record: List your last two full time or part time jobs (FT/PT)
______________________________________________________________________________________
(Employer)
(Type of Work)
(Phone #)
______________________________________________________________________________________
(Address)
(City/State/Zip)
Employed From: ____________________
To: ____________________
______F/T ______P/T
__________________________________________________________________________________
(Employer)
(Type of Work)
(Phone #)
______________________________________________________________________________________
(Address)
(City/State/Zip)
Employed From: ____________________
To: ____________________
______F/T ______P/T

Fathers Name and Occupation: ___________________________________________________________________

Mothers Name and Occupation: __________________________________________________________________
Siblings Names and Ages: ______________________________________________________________________
_____________________________________________________________________________________________
Are there any Siblings in your family in College? __________ Yes
Are there any Masonic affiliations in your family? __________ Yes

__________ No

How Many? __________

__________ No

Relationship: _________________________________________________________________________________
Name of Lodge or Masonic body __________________________________________________________________
Have you ever been charged or convicted of a felony? __________ Yes

__________ No

How did you hear about our scholarship program? ____________________________________________________

Do you support the Constitution of the United States of America?

Yes __________

No __________

A personal statement of your goals in life and your plan of achievement incorporating your educational goals: (Add
additional sheets if needed) _______________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

_____________________________________________________________________________________________
_____________________________________________________________________________________________

I certify that the information that I have given on this application is true and correct to the best of my knowledge on
the __________ day of ______________, 20_____.

SIGNATURE: _____________________________________________________________

Applicant's name __________________________

In Column "A" please list: Clubs, Teams, Organizations, Band, Choir, Track, UIL (use multiple lines as need)
In Column "B" indicate your position or office
In column "C" list any awards or honors
Mark the appropriate grades with and "X"
Expample:
Group
Annual Staff
Annual Staff
Football
Football
Football
Youth Ministry
A
Group

Position
Member
Editor
Member - Linebacker
Member - Linebacker
Choir member
B
Position

Awards / Honors

9th
X

10th 11th 12th

X
X
X
X
X
X
X
X
X
X
X
X
X

9th

10th 11th 12th

MVP
Captain
C
Awards / Honors