APPLYING FOR ACADEMIC YEAR _____ - _____ Please indicate the award you are applying for: I AM APPLYING FOR: Makarios Scholarship/Theodore and Wally Lappas Awards Makarios Scholarship/Thomas and Elaine Kyrus Endowment Makarios Scholarship/Peter G. and Bess Kolantis Decker Award Cyprus Children’s Fund Scholarship Endowment Cyprus Children’s Fund Awards –Solicited by Michael and Despina Anastasiou Cyprus Children’s Fund Stanley J. Dru Award SCHOLARSHIP APPLICATION Name:__________________________________________________Date of Birth:____________________ Address:________________________________________________Place of Birth:____________________ City:______________________________________________State:______________Zip:______________ Home Phone __________________________ Marital Status: Single Married Daytime Phone _____________________ Divorced Nationality:…………………………. Are you a U.S. Resident? Yes No Are you a U.S. Citizen? Yes No Are you on a foreign student visa? Yes No. If yes, please attach copy of visa and copy of your passport page(s) where name, date of birth, address, passport number and photograph appear. EDUCATION SCHOOL ADDRESS HIGH SCHOOL:_________________________________________________________________________ Grade Point Average________________________Date Attended____________ COLLEGE:______________________________________________________________________________ Grade Point Average________________________Date Attended____________ GRADUATE SCHOOL:___________________________________________________________________ 1 Grade Point Average_______________________ Date Attended______________ (Please attach official transcripts) 2. SCHOLARSHIPS OR AWARDS RECEIVED: (Please specify source and year): ___________________________________________________________________________________ ___________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 3. OTHER SOURCES OF FUNDING: (Please indicate amount and period during which aid is applicable) LOANS_____________________________________________________________________________ GRANTS__________________________________________________________________________ FINANCIAL AID_____________________________________________________________________ OTHER SOURCES: (Parents, etc.) _______________________________________________________________ 4. EXTRACURRICULAR ACTIVITIES: (Please list all academic, civic and community activities you are involved, positions held and dates) ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ 5. FINANCIAL NEED 2 A. Father’s full name and place of birth: ________________________________________________________ Occupation_________________________________Annual_Salary $...................... B. Mother’s full name and place of birth: ________________________________________________________ Occupation_________________________________Annual_Salary $...................... C. Spouse’s full name and Place of Birth: ________________________________________________________ Occupation_________________________________Annual_Salary $.................... 6. WORK EXPERIENCE (Please list employment) EMPLOYERS’ NAME AND ADDRESS Employment Period of ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ 7. PLEASE TELL US THE REASON FOR YOUR APPLICATION 8. HOW DID YOU FIND OUT ABOUT OUR SCHOLARSHIP FOUNDATION? 9. PLEASE TELL US THE SOURCE OF YOUR GREEK ORIGIN. 10. PLEASE GIVE US A BRIEF ACCOUNT OF YOUR FUTURE PLANS. 3 11. HAVE YOU EVER APPLIED TO THE CCF FOUNDATION BEFORE? Yes (If yes, please specify date)........................ No HAVE YOU EVER BEEN GRANTED AN AWARD BY THIS FOUNDATION? Yes (If yes, please specify date)....................... No 12. ARE YOU WILLING TO VOLUNTEER TIME TO THE CYPRUS CHILDREN’ S FUND? Yes No If yes, please state number of hours per week. ................per week. I agree that the decisions of the Scholarship Selection Committee are final. ________________________________________________________________________________ APPLICANT’S NAME Date: _________________________________________________________________________________ APPLICANT’S SIGNATURE Date: Telephone Number WITNESS: (Please have a witness sign this application.) _________________________________________________________________________ WITNESS NAME: WITNESS ADDRESS:________________________________________________ WITNESS’S SIGNATURE: __________________________________Date: __________________ Witness Telephone Number: 4
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