Student Scholarship Application Form
Optimist Club of Sun Prairie - Orville Frank $500 Scholarship

Deadline Sunday, March 118th

Name
Your answer
Home Address
Your answer
Home Phone
Your answer
Email Address
Your answer
Current Cumulative Grade Point Average
Your answer
Please describe any special honors or recognition you would like us to know about:
Your answer
Tell us what extra curricular activities you have been involved with during your high school career:
Your answer
Where have you been accepted for post high school education?
Please list institution and location of institution
Your answer
Why do you plan on going to this institution?
Your answer
Briefly tell us if you have worked with or supported children and/or youth groups or individuals in Sun Prairie.
Due to our mission, we strongly emphasize student involvement in working with youth in a variety of activities.
Your answer
Please list two adults we might contact as references:
Name, Phone, Email
Your answer
Please provide one word as a password, acceptance, and signature of this application.
Your answer
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