Application for the
American Legion Post 245 Vic Schiavone Memorial Scholarship
Poulsbo WA.
Full Name:_______________________________________________________________DOB:_________
Address:______________________________________________________________________________
City:_______________________________________State:_______________________Zip:___________
Phone:_______________________________EMAIL:__________________________________________
Spouse, Child/Grandchild of Veteran :____________________________________________________
Veteran Branch of Service:________________________
Dates Veteran Served:______________________, Attach copy of DD214 or proof of current service
Education Years Completed:___________________________ Current GPA:_______________________
Community Service
Performed:___________________________________________________________________________
School
Clubs/Associations:_____________________________________________________________________
Other:
(Awards/4H/BoyScouts/FFA)_____________________________________________________________
Education Institution (post-Secondary) which enrolled
and/or accepted for enrollment:__________________________________________________________
*Applicant shall attach a copy of a letter of acceptance, or copies of unofficial transcripts as proof of enrollment with this application. If awarded, scholarship check will be made payable to the institution.
Address/Phone:_______________________________________________________________________
This application is for the school year beginning in ___________________________________________
(month) / (Year)
NOTE: Applications must be post marked between 1 Jan and 1 May of the School Year
___________________________________________ ___________________
Signature of Applicant Date
Mail original signed and dated application and supporting documentation to:
American Legion Poulsbo Post 245
PO Box 678
Poulsbo WA 98370-0678