Rockford Chapter National Society

Daughters of The American Revolution

Scholarship Application

General Instructions:

Complete the following items and submit in the order listed below.

1. Scholarship application
2. Financial Need Form
3. Official transcript of high school grades
4. Two letters of recommendation (no relatives)
5. Personal essay (300-400 words)
6. List of activities, honors, significant accomplishments
7. Mail the above to Scholarship Chair listed at the bottom of the application by January 28th for State Scholarships; by February 15th for all others.

Application

Name of Student _________________________ Social Security # _____-___-_____

Permanent Address __________________________ Telephone (____)___________

____________________________________________ Zip Code ________________

Resides with__________________________________________________________

College you plan to attend_______________________________________________

Are you an American citizen? ______yes ______no

Name of high school from which you will graduate ___________________________

Address of high school ________________________ Telephone (____)___________

____________________________________________ Zip Code ________________

Is your high school accredited? ______yes ______no

Class size __________ Class rank __________ GPA __________

SAT Test Score __________ ACT Test Score __________

What is your educational objective? _____________________________________________

Scholarships will be awarded based on commitment to academic excellence and need. Scholarship winners will be announced in May. Thank you for applying and best wishes to you as you pursue your educational goals!

Rockford Chapter DAR Scholarship Chair:

Audrey Johnson Telephone: (815) 282-3537

2929 Sunnyside Dr. #366D

Rockford, IL, 61114