Howard County A&M Club Scholarship Application
Graduating Seniors: Deadline:  May 1		Date:
Enrolled College Students Deadline:  June 1
PERSONAL DATA
Full Legal Name:
Permanent Address:
Home Phone:	Social Security #:	Date of Birth:	U. S. Citizen:
	______-______-_________	____/____/______	___Yes___No
Email Address:	Cell Phone:
FAMILY DATA
	Father or Guardian	Mother or Guardian
Full Legal Name:
Address:
Occupation:
Employer:
Total number in family:	Number of family in college next fall (including yourself):
Family Income Range:	___  Under $20,000	___$20,000-$40,000	___$40,000-$60,000
	___$60,000-$80,000	___$80,000-$100,000	___over $100,000
HIGH SCHOOL
School Name:		Graduation Date:
Number of Students in Class:		Graduating Class Rank:
ACT/SAT scores:		GPA:
COLLEGE
College Name:	Hours Completed:	GPA:	DATES:
TEXAS A&M UNIVERSITY, COLLEGE STATION, TEXAS
Have you applied for TAMU admission?	Do you plan to enter the Corps of Cadets?
Have you been accepted for admission?	Do you plan to attend fall and spring semesters?
Expected TAMU Graduation Date:	Planned College Major:		TAMU GPA :
EMPLOYMENT HISTORY
Job Title	Name of Employer	Employment Time Period
Do you plan to work part-time in college?____Yes ____No  If so, how many hours per week?___hrs.

ACADEMIC RECOGNITION	Year
EXTRACURRICULAR ACTIVITIES	Year

EXPENSE ESTIMATION WORKSHEET
Estimate the expenses you anticipate at Texas A&M University during the fall and spring semesters.
Description:		Fall Semester		Spring Semester
Tuition		$		$
Room & Board		$		$
Books & Supplies		$		$
Fees & Other Expenses Related to Registration		$		$
Miscellaneous Expenses		$		$
	TOTAL	$		$
Briefly describe how your expenses will be paid (scholarships, personal income,parents or other family, student loans, etc.
REASONS FOR ATTENDING TEXAS A&M UNIVERSITY
REASONS WHY YOU WOULD LIKE TO RECEIVE THIS SCHOLARSHIP
I certify that the information in this application is correct to the best of my knowledge.  I further understand that submission of this scholarship application does not guarantee a scholarship award.  I hereby give my permission for this information to be released to the donor or potential donors of any scholarship for which I may be eligible.  I understand that I am expected to attend the Scholarship Auction that will be held on July 18, 2009 at the Moss Creek Ranch.  I understand that I must carry a minimum of 12 hours to be eligible for this scholarship and that grades are an important determining factor for future scholarships.  I understand that this scholarship will be divided between the fall 2009 and spring 2010 semesters.
__________________________________________________	_______________________________			____________________
Signature	Printed Name			Date
Please include a copy of high school
and college transcripts with application.
Mail scholarship application to:
Jerry Foresyth '72
2909 MacAuslin
Big Spring, TX  79720