Tessier Team Scholarship Application

THE TESSIER TEAM FOUNDATION
SCHOLARSHIP APPLICATION
Please write or print your answers clearly. If the application is illegible it will
be returned to you.

1

LAST NAME:

2

EMAIL ADDRESS:

3

MAILING ADDRESS:

FIRST NAME:

Street:
Zip
Code:

4

City:
DAYTIME PHONE NUMBER:

5

DATE OF BIRTH:

6
7

I certify that I am a United States Citizen or a permanent resident of the United States of America.
(Circle One)
Yes
No
Name of School/Organization Scholarship is being applied for:

8

Current School Enrolled In:

9

High School Seniors: I will be attending the following school in the Fall/Winter of 20_______.
Must provide proof of acceptance or current student enrollment from the above school is required
prior to receipt of funds.
SCHOOL:

10

Grade Point Average (GPA) (On a 4.0 scale):
Must provide proof of GPA with a transcript.
Name and address of parent(s) or legal guardian(s):
NAME(s):

11

State:

Month:

Day:

Year:

Current Grade:

ADDRESS:
12

List other financial assistance you will receive per semester or quarter:
PERSONAL:
OTHER SCHOLARSHIP(s):
STUDENT LOAN(s)
OTHER FINANCIAL RESOURCES:

$
$
$
$

Explain:

13

List your academic honors, awards and membership activities:

14

List your community service activities, hobbies, outside interests and extracurricular activities:

15

Please provide a personal essay with relationship to the type of scholarship you are applying for.

16

Please provide two (2) character reference letters.

THIS APPLICATION MUST INCLUDE THE FOLLOWING IF APPLICABLE:
1. Completed, signed application form.
2. Personal Essay.
3. Provide two (2) character reference letters.
4. A copy of your recent transcript.
5. A copy of the 201___ Student Air Report (SAR) from the Free Application
for Federal Student Aid (FAFSA)
6. Signatures of parent(s) or legal guardian(s).

Signature of Scholarship Applicant

Date

Signature of parent(s) or legal guardian(s)

Date

Signature of parent(s) or legal guardian(s)

Date