PESCOSOLIDO FAMILY SCHOLARSHIP FOUNDATION, Inc.

 

APPLICATION FORM 2021

 

 

NAME                                                                                    TEL. NO. (     ) _____-  _________

ADDRESS                                                    

                                                                                    Email (required for communication):                                                                                              _____________________________

 

PARENT OR LEGAL GUARDIAN                                                                                               

Address if different than above                                                                                            

 

ACADEMIC

 

CURRENT ACADEMIC AFFILIATION

 

High School                                                                Status                                     

                                                                                    (Senior, Junior….)

College Prep Course                                                   Yes                  No      

 

College or University                                                  Status                                     

 

Major                                                              

 

Grade Average Current Year                                                                                     

 

Grade Average Past Two Years                                                                                

 

SCHOOL OR COLLEGE ACTIVITIES:

List all school activities, including, but not limited to, extracurricular academic, intramural, athletic, dramatic, musical, volunteer services and leadership roles, as well as language clubs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACADEMIC AWARDS:      Honors or Special Recognition

 

 

 

 

 

 

 

 

COMMUNITY ACTIVITES:

List all volunteer services (non-salaried). Indicate type or service, length of time involved, location of agency and supervisor’s name.

 

 

 

 

 

 

 

MEMBERSHIP IN ORGANIZATIONS:

 

 

 

 

 

 

 

AWARDS (non-academic):    Honors, Special Recognition.

 

 

 

 

 

 

 

EMPLOYMENT:

List all jobs you have held. Include name of firm, position held, length of employment and name of your supervisor.

 

 

 

 

 

 

 

 

 

 

 

 

HOBBIES:     List activities and length of time/interest involved.

 

 

 

 

 

 

 

FOR ALL APPLICANTS:

Write in one hundred words or less why you wish to study in Italy its language, culture civilization and its history.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Why did you apply for this scholarship?

 

 

 

 

 

 

 

Deadline for submission of this form is MAY 22, 2021          

 

This completed form should be returned to the:  Pescosolido Family Scholarship Foundation, Inc.

                                                                                   c/o Lino Rullo, President

                                                                                   9 Dudley Road

                                                                                   Lexington, MA 02421