Orange Scholarship Fund
Student Application Form
Name of Applicant
Date of Birth
Social Sec. No.
Work Experience - (1) Place of work (2) Duties (3) Dates
1 2 3
1 2 3
Brief statement concerning your education goal
Do you plan to work while attending college? Yes
College/University applied to:
College/University accepted to:
Intended major - if known:
What have you done to acquire information/experience in the above area
of interest? If area of interest in unknown at this time, leave blank.
What do you hope to achieve by enrolling in your post-secondary school?
Name of other scholarships or financial aid programs you have or will
Name of other scholarships or financial aid programs you were awarded
and dollar amount:
Your current total savings /investments (include bank accounts, stocks,
Anticipated earnings this summer: $
Financial aid needed for the coming school year:
Of all the students who will apply for financial assistance through the
Orange Scholarship Fund, why should you be selected?
Note: If there is any additional pertinent information that would aid the committee in its deliberations
please attach a separate sheet.
Student Additional Pertinent Information Form
To be completed by the student if needed
I certify that the answers given above are complete and accurate.