Mid Columbia Bus Co., Inc.

Scholarship Application

Mid Columbia is Offering  1 $500.00  Scholarships

 for the year 2009-2010

The careful and detailed completion of the blanks on this form is very important.

Name of Applicant________________________________SS#____________________Age_________

Mailing Address:_______________________City__________________________State_____________

College of School you will attend______________________________________________________

College Address______________________________________________________________________

If you have selected a major field of study, please indicate:_____________________________

Applications for assistance from this fund must be filled by 5/10/2010 and presented to:

Arlington  High School Attn. Michelle Geer

Family Information:

Fathers Name_________________________Home Address____________________________________

Mothers Name________________________Home Address____________________________________

Essay: In one page describe your most significant accomplishment and explain why you believe it to be your most outstanding.

Please attach a copy of your High School Transcript

References: Give the names and addresses of two individuals who would recommend you.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

_________________________                                      ___________________________________________

               Date                                                                                    Signature of Applicant

Payment will be made after completion of 1^st quarter, and a copy of winter term enrollment submitted to Mid Columbia Bus Co., Inc.