AAUW Windward Branch
2010-2011 EDUCATIONAL GRANT APPLICATION
Name________________________________________________ Social Security #_________________________________
Permanent Address____________________________________________________________________________________
Telephone (day) ________________ (evening)________________ E-mail________________________________________
All household members:
Name Age Relationship to applicant Employer/School (2008-2009)
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Education:
High School or Equivalent:__________________________________________________ Year graduated:________________
College: Name City,State Dates Attended Major Degree/Year
____________________________________________________________________________________________________
____________________________________________________________________________________________________
College you will attend in 2010-2011:_______________________________________________________________________
(Attach letter of acceptance if college transcript does not show current enrollment)
Major: _______________________________________________________________________________________________
2009 Total Household Income:
Income from all sources:_____________________________________
Please List Other Resources: (i.e.; Child Support, Trust Funds, Savings Accounts)
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Have
you received or applied for other financial aid? Yes___________ No__________
If yes, which source and how much have you received?_________________________________________________________
Paid Work Experience (List last job first):
Dates/Name of Business/Position
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Activities: List school, community or volunteer activities and offices held:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
References: List the names of those who have agreed to write letters of recommendation on your behalf.
Name Telephone Number
I.___________________________________________________________________________________________________
2.__________________________________________________________________________________________________
I hereby state that to the best of my knowledge all the information given in this application is complete and accurate.
Signature Date
(mail completed form to Alta Bento, 428 N. Kainalu Drive, No. A, Kailua, Hawaii 96734)