HOOVER-KOKEN FOUNDATION, INC
HOOVER-KOKEN FOUNDATION, INC.
STUDENT APPLICATION FOR GRANT-IN-AID
(Application Deadline: May 1)
Please attach a transcript of your previous year's high school or college credits, whichever applies.
Mail to: Hoover-Koken Foundation, Inc.
811 North Washington Street
Junction City, KS 66441
Phone No.: 785-238-3126 Fax No. 785-238-1717
Email Address: edwards@
APPLICANT INFORMATION
Name in full _____________________________________________ Social Security Number ____________________
Home Address _______________________________________ City/State/Zip Code _______________________________
Phone Number _______________________________________
Birth Date ____/_____/_____ Male _______ Female _________
EDUCATION STATUS
Graduate of ____________________________________ High School Year _______
College Classification _____________ Major ________ Minor _______
College or trade school you plan to attend (or are attending):
_____________________________________________________ Name
_____________________________________________________ Address/Aids & Awards Office
_____________________________________________________ City/State/Zip Code
Vocational objective ___________________________________________
Starting Date _________________ Date of Graduation _______________
Note: If you have attended college and are not in attendance at the present time, please explain:
______________________________________________________________________________________
Briefly, summarize your school, church and/or community activities. List any organizations to which you belong and offices you have held.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Commute ( ) Live on Campus ( ) Other (specify) _________________________________________
Anticipated College Major(s) _______________________________________________________________
Briefly outline your job/career goals
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
EXPENSES AND RESOURCES
Awards are given on the basis of financial need and scholastic potential. Study carefully the latest catalogues from the school of your choice in completing the budget.
Application period beginning ____________ and ending ____________
(All applications are for a maximum of 12 months only.)
Expenses Resources
Fees and tuition _____________ Personal savings ____________
Books and supplies _____________ Earnings ____________
Room/Board _____________ Aid from parents ____________
Clothing _____________ Aid from Scholarships
Personal & and Grants ____________
Recreation _____________ Other resources (specify) ____________
Other _____________
Total _____________ Total ____________
Indicate what you are doing or will be doing to help meet your anticipated college expenses. Include how you have earned or saved money and what your plans will be for the coming summer.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
REFERENCES
Please give three adult, non-relatives, as references. List one teacher or faculty member from last school attended.
Name Address Position
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
PARENT OR GUARDIAN INFORMATION
Name(s) in full _______________________________________________________________________________________
I live with: ( ) Mother ( ) Father ( ) Step-mother ( ) Step-Father ( ) Other ___________ (please specify
Permanent Home Address _____________________________________________________________________________
Father’s Occupation ___________________ Employer _________________________ Address ______________________
Mother’s Occupation __________________ Employer __________________________ Address ______________________
Children older than you _________ Younger _______ Total number in family ________________
Total Family Income: (Check One)
Under $20,000 ( ) $20,001 - $27,500 ( ) $27,501 - $35,000 ( ) $75,001 - $100,000 ( )
$35,001 - $42,500 ( ) $42,501 - $50,000 ( ) $50,001 - $75,000 ( ) $100,000 - Up ( )
Are there any special family financial considerations you wish the scholarship committee to be aware of?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
_
I hereby authority the representatives of the Hoover-Koken Foundation, Inc., Junction City, Kansas, to make any financial investigation that is necessary in connection with this application. This may include information from the Social Security Administration, Veterans Administration, Welfare Department and financial institutions such as banks, building and loan companies, etc.
________________________________
Signature - Applicant
________________________________
Signature - Parent
Date _______________________
Hoover-Koken:APPLICATION.5-19-09
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