Grahame Butler-Nixon Scholarship Application

Grahame Butler-Nixon Scholarship Application

The information provided on this form will be used by the Grahame Butler-Nixon Scholarship Committee of Grace Episcopal Church, Camden, S.C. to select recipients for scholarships. Please answer openly and honestly allowing the committee to gauge eligibility and merit.
BASIC INFORMATION
Student's Full / Legal Name*

First NameLast Name
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Phone Number*

Area CodePhone Number
Student E-mail*
Student Birth Date

MonthDayYear
Gender
(optional)

Academics
Academic GPA*
Class Rank
Schools to which you are applying
School 1
School 2
School 3
Major(s) You Are Considering

In order of preference, list the major(s) you are considering.
Major 1
Major 2

REFERENCES:

Please list one educator and at least one community person who would recommend you for a scholarship.
Reference 1 Name (Position,Phone Number)
Reference 2 Name (Position,Phone Number)

SCHOOL / COMMUNITY ACTIVITIES / WORK / EXPERIENCE/SPORTS/AWARDS/ETC:

List name of club, etc. and years of participation. If you volunteered, list the name of organization and the number of hours, weeks and years that you volunteered. If you worked, list the company, hours per week and length of time. Attach an additional sheet or resume if necessary.
School Activities / Offices Held 1: (not sports)
School Activities / Offices Held 2: (not sports)
School Activities / Offices Held 3: (not sports)
School Activities / Offices Held 3: (not sports)
Community Service / Volunteer Activities 1 (outside of school)
Community Service / Volunteer Activities 2 (outside of school)
Community Service / Volunteer Activities 3 (outside of school)
Sports Participation 1
Sports Participation 2
Sports Participation 3
Travel Experience or Unusual Experiences (study abroad, etc.)
School / Community Awards and Honors 1 (no matter how small) CSF, GSE, National Honor Society, Girl/Boy Scouts, 4-H, Governor’s Scholar, etc.
School / Community Awards and Honors 2
School / Community Awards and Honors 3
EMPLOYMENT 1: List past and present work and length of time employed.
EMPLOYMENT 2: List past and present work and length of time employed.

BASIC INFORMATION