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A. Status of Applicant (Check one): |
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| i) | Former Spencerian  |
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| | Maiden name (if applicable): _______________________________________________ |
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| | Grade Level(s) & Year(s) Attended: __________________________________________ |
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| ii) | Relative of Spencerian  |
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| | Relationship (daughter/sister etc): ___________________________________________ |
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| | Name & Address (if applicable) of Relative (include maiden name): |
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| | ___________________________________________________________________ |
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| | ___________________________________________________________________ |
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| | ___________________________________________________________________ |
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| | Grade Level(s) & Year(s) Attended: __________________________________________ |
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| iii) | Other  |
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B. Future Post-Secondary Institution: |
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| Planned Program of Studies: ____________________________________________________________ |
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| Length of Program: _________________________ Level Entering: _________________________ |
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| Name of Post-Secondary Institution: __________________________________________________________ |
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| Address of Post-Secondary Institution: | _______________________________________________________ |
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| | _______________________________________________________ |
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| | _______________________________________________________ |
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C. Education: |
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| i) | For Applicants currently in High School |
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| | Name & Address of High School: __________________________________________________________ |
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| | ____________________________________________________________________ |
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| | Scholarship Examination Number (NF students only): ______________________________ |
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| ii) | For Other Applicants |
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| | Are you currently in school Yes _______________ No _______________ |
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| | Name & Address of Current Institution: ____________________________________________________________ |
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| | _____________________________________________________________________ |
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| | Is this a Post-Secondary institution Yes _______________ No _______________ |
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| | Name of Studies & Description: _______________________________________________________ |
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| | _____________________________________________________________________ |
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| | _____________________________________________________________________ |
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| iii) | High School Graduation Status: |
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| | High School Graduate | | ____________ | | Year | | ____________ |
| | GED Graduate | | ____________ | | Year | | ____________ |
| | ABE Graduate | | ____________ | | Year | | ____________ |
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D. Extra-Curricular Activities: |
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Please check all appropriate Organization |
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| | | | Currently | | Past Participation |
| | Girl Guides/Pathfinders | | ____________ | | ____________ |
| | Church Groups | | ____________ | | ____________ |
| | Sports | | ____________ | | ____________ |
| | Crafts | | ____________ | | ____________ |
| | Volunteer organizations | | ____________ | | ____________ |
| | Music/dramatics/dance | | ____________ | | ____________ |
| | Other | | ____________ | | ____________ |
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Please expand on above involvement or attach a letter
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| ______________________________________________________________________ |
| ______________________________________________________________________ |
| ______________________________________________________________________ |
| ______________________________________________________________________ |
| ______________________________________________________________________ |
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E. Financial Need (optional): |
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Have you applied for Student Aid? Have you been approved for Student Aid?  |
| | Please attach other financial information that you would like the committee to take into consideration (please be assured all
information given will be considered confidential) |
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Signature: ___________________________________ Date: _________________________
Please attach all documentation including the personal letter
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