4.0 KiB
Mailina address
NOTTION SOND
Tast Name
Dhano Mumhor
Hiah School Attended
LEANDER
First Name
Middle Name (or
Zio Code
Date of Rirth
Email Addrocc
Gender ( M/F)
US Citizen
Scholarship Application Norton Moses Masonic Lodge, #336 $1000 Scholarship Award
Last Name
First Name
Middle Name (or Initial)
Mailing address
City
Zip Code
Phone Number
Date of Birth
Email Address
High School Attended
Gender ( M/F)
US Citizen
Eligibility and Requirements
- Be a graduating senior from any LISD High School
- Complete and sign this form, including signature of H.S. Counselor or Principal
- Attach a copy of your High School transcript to this application
- Attach a double spaced, 750-word essay on the
- following selected topic:a. The Contributions of Freemasonry in Texas History
- I hereby grant permission for my essay to be used in Masonic publications
- I hereby authorize Leander ISD to make available to Norton Moses Lodge Scholarship committee information concerning my academic records
Counselor or Principal's Certification
I hereby certify that the academic information and summary of school activities as submitted are true and correct to the best of my knowledge
Applicant's Certification
I hereby certify that the academic information and summary of school activities as submitted are true and correct to the best of my knowledge. I understand that submitting false information will automatically disqualify me from consideration for a scholarship.
Counselor or Principal Signature and Date
Student Applicant Signature and Date
Name of College or University in order of
Date
Norton Moses Masonic Lodge Scholarship Committee PO Box 586 Leander TX 78646
Date
Citv
| preference | Applied | Accepted |
|---|
High School Sponsored Activities (Clubs, Athletics, Band, JROTC, Etc)
| Name | Yr 09 | Yr 10 | Yr 11 | Yr 12 | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned | Description of how honor was earned |
|---|
Academic Honors or Other Achievements
| Name | Yr 09 | Yr 10 | Yr 11 | Yr 12 | Description of how honor was earned |
|---|
Employment
| Name | Yr 09 | Yr 10 | Yr 11 | Yr 12 | Average Hours per Week/per Year | Average Hours per Week/per Year | Average Hours per Week/per Year | Average Hours per Week/per Year | Average Hours per Week/per Year | Average Hours per Week/per Year |
|---|
Community Activities
| Scouts, DeMolay, Rainbow Religious Etc. | Yr 09 | Yr 10 | Yr 11 | Yr 12 | Average Hours per Week/per Year |
|---|
Scholarship Application Deadline is April 15 th 2020
Norton Moses Masonic Lodge Scholarship Committee PO Box 586 Leander TX 78646