GENERAL APPLICATION FOR SCHOLARSHIP
Date:    ____________Applicant's Full Name: _____________________________________
Please State your Qualifying Status Under Section 
You a current member___________________________________
Your parent or legal guardian is a current member_____________________________
You are a dependent of a deceased person who served with the 11th Armored Cavalry
in Vietnam or Cambodia______________________________________________
Troop Served with _____________________Dates in Vietnam ___________________
SSAN: ______________________________
Address: Street:  ___________________________________ Apt# ________________
City:     _________________________________, St: _______ZIP:     ________  _____
DOB: ___________________TEL:  (___) _____  ___________
Parent's  Name = Father ______________________Mother____________________ 
or Guardian Full Name:______________________________________________
(must include a copy of members current 11th ACVVC membership card)
Name and address of College/Trade School you plan to attend:
_____________________________________________________________
Telephone number of admissions office  (       ) _____________________
Have you made application ?       YES__________    NO______________
Have you been accepted ?           YES__________    NO_______________
The Standard Test For Your State ACT Score: _______   SAT Score: _____   (Test)_____ (score)_______
Estimated expenses for the school year
1.  Tuition & Fees                         $_________________________________
2.  Room & Board                        $_________________________________
3.  Books & Supplies                   $_________________________________
4.  Miscellaneous Expenses        $_________________________________
                                    Total:        $_________________________________

You must include a copy of your grades from ninth grade to present. Include grades
you have received in college. 
Schools attended (ninth grade to present)
School Name:                                   Date Started:                      Date Ended:
________________________________________________________________
Telephone number of guidance department of last school attended:(     )______________
What field of study do you plan to enter & why?__________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Please tell us, in the space provided, why you would be a worthy recipient of the 11th ACVVC. Scholarship.________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
I the undersigned, give my permission for a copy of my official high school transcript and /or college transcript to be submitted with this scholarship application. I understand that the selection process may involve a committee composed of individuals that are in the community at large.
__________________________________  ____________________________________
( signature of applicant )     ( date of signature )
__________________________________  ________________________________________
( parent or guardian if applicable )    ( date of signature )