Butternut Community Foundation Scholarship Application
Please complete the following information accurately.  Any missing information or inaccurate information will delay the processing of the scholarship funds to be sent to the post-secondary institute.  All responsibility is on the student applying for scholarship. Application must be typed. Submit your application to the School Counselor no later than April 15th. All additional materials may be submitted to the School Counselor or the Butternut Community Scholarship Foundation Board at:

P.O. Box 247
Butternut, WI 54514

Be sure to submit a copy of:

*signed copy of the Agreement to Terms and Conditions page
(found in the Butternut Community Scholarship Guidelines, page 7)

*copy of applicant’s high school transcript (Due July 1)

*copy of an acceptance letter to student’s post-secondary institution (Due August 15 or upon acceptance)

*copy of the student's semester class schedule (Due August 15 or upon acceptance)


Please note that institution refers to the college, university, technical college, online school, or trade school.
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Expected Graduation Date: *
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Full Name of Applicant: *
(applicant's legal name)
Mailing Address: *
Email Address: *
Cell Phone Number *
Applicant's Date of Birth *
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Have you applied to post secondary institution? *
(check one that applies to you)
If yes, where:
(name of institution to where you applied)
Have you been accepted?
(check one that applies to you)
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If yes, list your intended program of study:
Phone Number of Financial Aid Office:
Mailing Address of Institution:
Fax Number:
Check each grade you have attended at the Butternut School District? *
select all that apply
Required
By typing my full name below I understand that I need to include a signed copy of the Terms and Agreement page, (found in the Butternut Community Foundation Scholarship Guidelines Packet: Page 7), my high school transcript, a copy of the acceptance letter to the educational institute, and my semester's schedule, along with my application. *
Today's Date: *
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