ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
Visalia Masonic Lodge Scholarship
2
Application Form
3
4
Deadline to submit application to the Lodge is April 15, 2026
5
Submit to
6
Masonic Scholarship Committee
7
PO Box 128
8
Visalia, CA 93279
9
or email to: visaliamasoniclodge128@gmail.com
10
Award notification will be done using the email you list below -
please be sure to check your email so you don't miss any notifications.
11
12
"Service to Others" PERSONAL ESSAY- required
13
Please submit a short (1-2 pages) original essay describing their career plans and how your choice of career will benefit humanity
14
15
STUDENT INFORMATION
16
17
SCHOOL
18
19
FULL LEGAL NAME
20
Last
First
MI
21
** PLEASE WRITE YOUR NAME AS IT APPEARS ON YOUR SCHOOL RECORDS
22
23
ADDRESS
PHONE NUMBER
24
25
CITYZIP
26
27
EMAIL ADDRESS
28
29
DATE OF BIRTH
PLACE OF BIRTH
30
31
MASONIC AFFILIATION (IF ANY, NOT REQUIRED)
32
33
FATHER'S NAME (or Guardian)
34
35
FATHER'S OCCUPATION
36
37
MOTHER'S NAME (or Guardian)
38
39
MOTHER'S OCCUPATION
40
41
NUMBER OF SIBLINGS LIVING AT HOME
NUMBER OF SIBLINGS ATTENDING COLLEGE
42
43
EDUCATIONAL AND VOCATIONAL PLANS
44
45
ANTICIPATED COLLEGE MAJOR
46
47
VOCATIONAL/CAREER PLANS
48
49
SCHOOL PLANNING ON ATTENDING
50
51
ACTIVITIES RECORD
52
NAME
SCHOOL
53
STUDENT GOVERNMENT
54
GRADE9
55
10
56
11
57
12
58
59
ORGANIZATIONS/CLUBS
60
GRADE9
61
10
62
11
63
12
64
65
ATHLETICS
66
GRADE9
67
10
68
11
69
12
70
71
AWARDS/HONORS
72
GRADE9
73
10
74
11
75
12
76
77
COMMUNITY ACTIVITIES
78
GRADE9
79
10
80
11
81
12
82
83
HOBBIES
84
85
86
EMPLOYMENT
87
GRADE9
88
10
89
11
90
12
91
92
93
94
95
96
97
98
99
100