top of page
Log In
About
"Uncle Dan" Wheeler Story
Lodge Officers
Committees
Office Staff
Elk of the Year
PER Association
Lodge History
NSEA
Lodge
Facilities
Rental Rates
Facility Rental Insurance
"ELK"standing Volunteers
Privacy Policy
Terms and Conditions
Event
Upcoming Events
Past Events
Programs
Drug Awareness
Elks National Foundation
Hoop Shoot
Hunters
Scholarship/Vocational
Veterans
Member Area
Member Page
Blog
The Call
More
Use tab to navigate through the menu items.
2024 David J. Tacchino Scholarship and Education Grant Application
Student Infromation
First Name
Address:
Date of Birth
Last Name
Phone Number:
U.S. Citizen or Legal Resident
Email
Cell Number:
Place of Birth
Graduation Date:
GPA:
Weighted GPA:
Check all that apply to you.
AP Courses
International Baccalaureate
Dual Enrolment
Grade Recevied
Have you taken a class in American History?
Yes
No
Are you a candidate for a Honors Diploma?
Yes
No
Institution(s) of post-high school study. List in order of prefrence.
Number of semester classes you have completed in honors courses.
English
Math
Science
Social Studies
Proposed major or collegiate / trade school field(s) study:
Number of semester classes you have completed in elective courses.
Art
Foreign Languge
Economics
Music
ComSci
Honors and Awards: Include scholastic, extracurricular and civic honors and awards during grades 9 through 12. State nature of award and grade won: i.e. Girl Scout Gold Award, 12. Please do not abbreviate names of awards.
Positions of Leadership: State name of organization, position and grade(s). Indicate position held from grades 9 through 12, starting with most recent: i.e. Class President, 12, 11. Key Club President, 11. Tennis Team Captain, 1
Activities and Organizations Include all scholastic, extracurricular and civic organizations that you have participated in during grades 9 through 12, including those listed in the “Positions of Leadership” section above. State name of organization and grades you were involved in, starting with those you participated in for 3 or more years then 2 years then 1 year.
Employment and Community Service: List jobs you have held. Include baby-sitting and work on a family farm or for a family business, even if not paid. Please list total hours worked, not average hours per week. You will receive 0 point in this section if you do not list your hours as indicated
List volunteer work or community service you have performed without pay. Inlude total hours, dates and organization.
Total Number of Hours of Service
List three teachers or community leaders, name and position, who have written a letter of recommendation for you. (Attach letters - Letters must be signed and dated, and must not exceed one page in length)
STUDENT ESSAY (Part 1): In the space provided, briefly state your goals and objectives for continuing your education. Upload document below if more than 200 words.
STUDENT ESSAY (Part 2): State what the American Flag means to you. (Please limit to 200 words or less)
Proposed Budget for your first year of highe larning. Brackdown should include: Room & Board, Clothing, School Supplies, Tuition, Transportation
Estimated Income.Breakdown should include: Employment, Aid from Parents, Savings, Scholerships, Other
Financial Statement - To Be Completed By Parents or Guardian (All responses wil be hed in strict confidence). Name of Parent(s) / Guardian(s)
Number of other children in the family: Include age.
Number of other children in collage:
Does the applicant work? Type of work?
Mother / Guardin Occupation:
Annual Gross Income (IRS Form 1040)
Under $20,000
$20,000 - $40,000
$40,000 - $60,000
$60,000 - $80,000
$100,000 - $150,000
$150,000 - $200,000
$200,000 and Up
Could the applicant attend college without financial aid?
Yes
No
Father / Guardin Occupation:
Home:
Rent
Own
Home Equity:
If own, what is the Market Value:
Mortgage Owned:
Total Other Assets:
Accounts, Stocks, etc.
Medical Expenses: Amount of Mecdical / Dental expenses paid this year that were not covered by insurance:
Please add any additional remarks or information about your family status which you feel might assit the commitee. Attach sheets if necessary.
Additional Documents:
Upload File
Parent / Guardian Signature
Clear
Parent / Guardian Signature
Clear
All informaton given within this appication is true, complete and correct.
Your Signature
Clear
I want to subscribe to the newsletter.
Send
Thanks for submitting!
bottom of page
