Scholarship Application form:    
Fairmont Senior High School Foundation, Inc.
      One Loop Park   *  Fairmont, West Virginia 26554

Please print or type:                                                                           Date of application: ________________

1.        Name: _____________________________________________________________

2.        Address: ___________________________________________________________

3.        Current cumulative GPA:    _______________ (minimum 2.0 required)

4.        Planned college, university, technical/trade school and  area of study:
           ____________________________________________________________________________________

5.       As of this date, have you been advised of or received any grants, financial aid
          or scholarships?              [   ]  Yes         [   ]  No
          If yes, please identify each award and amount:
           ___________________________________________________________________________________
          Note: The Foundation generally does not provide a scholarship if you have received a major scholarship from a college or university. Please keep this in mind when submitting an application for a Foundation Scholarship. This helps the Foundation reach a broader base of
students who are in need of financial assistance for college.   Foundation Scholarships are $500 and are presented each year at the Senior Recognition Assembly.   You must be present to receive the award unless you are excused for a school event or activity.

6.       List your community activities and your volunteer service experience:

          ____________________________________________________________________________________

7.       Briefly explain your reason for applying for this scholarship:
          ____________________________________________________________________________________
        [   ]     I am planning a career in social work, human services, counseling or therapy fields*
        [   ]     I wish to be considered for the Tyndara Meffe Scholarship*
        [   ]     I wish to be considered for the Delores Maruka Scholarship*

* Note:     The Anthony Pizatella Scholarship is awarded to students planning a career in social work, advocacy, counseling or other related therapy areas. Please indicate if you are planning a career in these fields to be considered for this scholarship awarded through the FSH Foundation.   The Tyndara Meffe Scholarship is awarded for creativity. Applicants for the Meffe Scholarship are selected by the English Department but a form must be completed in order to be considered.    The Delores Maruka Scholarship is funded by the Maruka family.

I verify that the information in this application is true: ___________________________________
                                                                               Student signature

                                                                               ___________________________________
                                                                               Parent or guardian signature

I recommend this student for consideration:             ___________________________________
                                                                               Teacher or counselor signature

Applications for scholarships are to be returned by May 1st of each year to Counselors or Principal's office.