How did you hear about the scholarship fund?

Course interested in: Date: Fee:

Name:

Address:

Phone: (Home) (Work) (Fax)  

eMail:  

Education (most advanced degree):

Occupation:

Prior woodworking experience (Including prior courses taken):

List two references who know you well and are aware of your woodworking interest

Name:   Phone:

Address:

Name:   Phone:

Address:

Permission granted to contact listed reference.

Why do you believe you're qualified to receive a scholarship award?

What contribution will you make to the craft of woodworking once you've completed the program?

I have read and agree to all the scholarship criteria (see attached.)

I hereby certify that my household income is less than $50,000 annually.

If annual income is greater than $50,000 describe financial circumstances that warrant need for scholarship:

Signature: Date: