Scholarship Application Form

	DIANE CHRISTODOULOU MEMORIAL SCHOLARSHIP OBJECTIVE CRITERIA - PAGE 2 (to be completed by student)
	V. School Activities Please list any organizations, clubs, sports, music, drama, etc. that you have participated in school other than academic here: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________
	VI. Community and Other Activities Please list any organizations, such as scouts, 4-H, church, camp, etc. that you have participated in here: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________
	VII. Plans for Higher Education Please tell why you would like to continue your education. _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
	VIII. College Major or Area of Interest _________________________________________________________________ _________________________________________________________________
	IX. Interests/Hobbies _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
	X. Career Goals _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
	XI. Work Activities Are you now employed? ___________ yes _______________no If yes, what type of work? ____________________________________________________
	XII. Financial Need Please check the figure that best describes your family's adjusted gross income: _____ Under $20,000 _____ $20,000 to $50,000 _____ Over $50,000 Total Number of Family Members Living at Home ______________ Number of Persons age 18 and Under Living at Home ______________ Total Number of Persons Presently Attending College ______________ Continued on next page.