ASQ
Larry Turbett Memorial
Scholarship Application
For the Year 2011
Please fill out the
application completely. If there is
insufficient space provided under any of the entries below, attach supplementary
sheet(s). Additionally, please attach a copy of your most recent transcript
as “Attachment A”.
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Name |
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Birth
Place |
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Street
Address |
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Age |
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City,
State, Zip |
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Email Address |
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Telephone
No. |
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Sponsor Name |
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Part 2 Education History
A.
List all Schools Attended
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School
Name |
City |
State |
Year
start |
Year
end |
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B.
What extracurricular activities were you actively engaged in at school?
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Name
of Organization/Activity |
Honors
or Offices Held |
Years |
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C.
List other activities or hobbies you were interested in:
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Name
of Organization/Hobby/Activity |
Honors
or Offices Held |
Years
Participated |
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D.
What subjects were you most interested in high school?
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E.
What college do you plan to attend?
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3. Signature(s)
_________________________________ _________________________
Signature
of Applicant Name
and Signature of Sponsor
_________________________________ __________________________
Date
Sponsor’s
Membership Number
Note(s):
1. The applicant
should attach a copy of his/her most recent transcript as “Attachment A”.
[If the applicant took the SAT, ACT or similar
tests, AND if the scores from
these tests are not reported in the transcript, please provide those test
scores, separately from the transcript.]
[If the High School does not report Rank In Class on the transcript, please provide this information
separately, if known.]
[If the HS does not report HSPA results on the
transcript, please provide separately, if available.]
2. The sponsor should
enclose a copy of his/her membership card marked “Attachment B”.
3. Applications
postmarked after
4. The optional essay will be used as a tiebreaker
in evaluating applicants.
Mail application to:
Ed
May, ASQ Chapter 304