A COPY OF YOUR MOST RECENT HIGH SCHOOL OR COLLEGE GRADE TRANSCRIPT
MUST ACCOMPANY THIS APPLICATION.
Note: You must have been accepted for admission to an Accredited College or University with a curriculum
major of journalism, the arts, or fine arts before
this scholarship application will be acted on.
Millersport Community Theatre
Glenna Parkinson Memorial Scholarship
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Name__________________________________ Contact Phone Number___________________________________
Address _____________________________________________________________________________________
Father's Name _____________________________Mother's Name _______________________________________
Address__________________________________Address______________________________________________
Occupation _______________________________Occupation____________________________________________
How many children in your family_______________How many children still at home____________________________
Are you currently employed______________ Where____________________________________________________
College/University you are planning to attend__________________________________________________________
What is your intended cousre of study?_______________________________________________________________
How much of your college expense are you, personally, prepared to pay_____________________________________
High School attended_______________________________Date of graduation_______________________________
List High School Activities and Extra-Curricular's including offices held.
______________________________________________________________________________________________
______________________________________________________________________________________________
Please give a concise statement of your need for this scholarship.
______________________________________________________________________________________________
______________________________________________________________________________________________
Interested hobbies________________________________________________
Community Activities______________________________________________
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Name three teachers that you have had in high school/college who are presently on the staff:
(1)_____________________________(2)___________________________(3)______________________________
Millersport Community Theatre, P.O. Box 637, Millersport, Oh 43046
APPLICATIONS MUST BE RETURNED BY MAY 8, 2010
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