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Friends of Wilson Lake

David Prince Memorial Scholarship Application

Complete the following application form, short essay and include your high school transcript. All forms

must be submitted to the Mt. Blue High School Guidance Office by the last Friday in April. Students will

be notified at the MBHS Awards Assembly. Award will be applied to the second semester tuition

payment.

Name: __________________________________________________ Class Rank: ______________

Address: _____________________________________Town: _______________ Postal Code: _______

Phone: _____________________ Email: ________________________________________

Name of parent(s) or guardian with who you reside: __________________________________________

Parent(s)/Guardian(s) occupations and employers: _____________________________________________________________________________________

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Ages of siblings/step siblings: ___________________________________________________________

Total number of people living in the home: _______

Total number of household members attending college next year (include yourself): _____________

College/School you will attend: __________________________________ Location: ______________

Possible major/minor program of study: _________________________________________________

Current career goals: _________________________________________________________________

Total financial aid awarded from college: ________________________ Other: __________________

Estimated costs of college for next year: Tuition: ________________

Room and board: _______________

Fees: _______________

TOTAL: _________________

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Friends of Wilson Lake

David Prince Memorial Scholarship Application

Work Experience (list employer, position and dates of employment)

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Extracurricular Activities (include school, community service, leadership roles, awards)

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Essay – attach an essay of less than 250 words (typed) explaining why you should be granted this

scholarship.

Check off items included: ___ 1. Completed application form

___ 2. Essay of 250 words or less

___ 3. Official high school transcript

Applicant signature: ___________________________________ Date: _____________