PAEOP Student Scholarship Application

1. Complete this form.
2. Print 2 copies (one for your records and mail one to the address below).

Personal Data

Name: (Last)

(First)

(Initial)

Address:

Date of Birth:

Telephone:

Name of parent(s), guardian or spouse:

Address of parent(s), guardian or spouse:

Number of children in same household:

Number of children attending college:

Name of high school you attended or graduated from:

Date/anticipated date of high school graduation: (month/year)

Approximate scholastic grade point average:
(attach official transcript and recommendation from business education teacher and/or school counselor)

List extracurricular activities, honors, community service:

Financial Data

Parents' or guardians data:

Applicant and/or spouses' data:

Annual income:

Annual income:

Can you expect financial assistance from your parent(s), guardian or spouse?

If yes, please specify( room, board, books, other):

Will you be supplementing your education through employment?

Have you applied for other scholarships or financial aid?
If yes, how much?

Return by March 1 to:

Joanne Brindle or Diane Readinger
103 School Street Pine Grove Area School Dist.
Pine Grove, PA 17963
email - jbrindle@pgasd.com or dreadinger@pgasd.com