APPLICATION FOR SCHOLARSHIP. Please mail applications to: C.C.S.F. Inc. P.O. Box York, PA 17402

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CHRISTOPHER COLUMBUS SCHOLARSHIP FUND, INC. P.O. Box 21492 York, Pennsylvania 17402 ESTABLISHED BY THE SONS AND DAUGHTERS OF ITALY LODGE 528 WWW.CCSFYORKPA.ORG Awards Four - $2,000.00 each Applications Available December 18 th 2017 Application due... March 9 th 2018 Notification of Acceptance. April 13 th 2018 Please mail applications to: C.C.S.F. Inc. P.O. Box 21492 York, PA 17402 ALL applications must be received NO later than March 9 th 2018 A copy of the application form is acceptable 1

Christopher Columbus, the 15 th century Italian navigator, sailed under a Spanish flag to explore a route to the Orient. Instead, Columbus landed in the Americas and thus opened a new land to European influence. The world has been profoundly different since that discovery. America has become revered the world over as a land of opportunity. The qualities embodied by the image of Columbus such as intellect, perseverance and courage, are worthy of emulation by any age or any person. In the context of fostering these characteristics, the Christopher Columbus Scholarship Fund, Inc., wishes to offer opportunities to students for a quality education. Perhaps a new Columbus can be produced whose discoveries will make a profound impact on people s lives. The Christopher Columbus Scholarship Fund, Inc. will grant four scholarships of $2,000.00 each; for the 2016-2017 school year. Applicants must be high school seniors and residents of York County at the time of application and must have been accepted by an accredited four-year institution of higher learning. The scholarships have no age restriction. They are available to all York County Residents regardless of race, creed, color, religion or national origin. The scholarships will be given to York County students based on academic potential and where financial need is the principal criterion. Scholarship committee judges will determine the recipients. Applications are available at the guidance offices of all York County high schools and on the website after December 15 th 2016. Applications must be received by March 10 th 2017 to: Christopher Columbus Scholarship Fund Inc. P.O. Box 21492 York, PA 17402 2

PERSONAL INFORMATION Current address: Email: Mobile #: Date of Birth: Father s FAMILY NAME OF PARENTS OR GUARDIAN Mother s High School: SCHOLASTIC INFORMATION Graduation Date: Class Rank: Students in Grad. Class: SAT Scores: Verbal: Math: Writing: Total: Extracurricular Activities and/or Community Activities: Honors/Awards: College/University Applied To (include Branch if applicable, i.e. Penn State York ) : First Choice: Second Choice: Third Choice: Field of Study: Intended Degree: Circle one: Full Time / Part Time 3

If working, your employment: Present Employer: EMPLOYMENT INFORMATION MOST RECENT Total combined gross family income per year: APPLICATION INFORMATION CONTINUED ESTIMATED ANNUAL SCHOOL EXPENSE PER YEAR How many family members (including adults) are dependent on the combined income? Have there been any unusual expenses for you or your family? If so, please explain: Anticipated Tuition Per Year: Expected Room & Board Per Year: Total: How do you plan to finance the remainder of your college/school year? Amount your family will pay: Amount you personally will pay: Other financial resources: What other scholarships, grants or loans have you sought? How much scholarship aid have you received? From where? ESSAY Please provide a short essay regarding your hopes for a future occupation and your plans for community involvement after your formal schooling. Please include your personal interests, activities and hobbies etc. that will lead you toward these plans. Also, please write a paragraph explaining how this scholarship will help to further your educational goals. Please ATTACH the essay to the end of this application. 4

SCHOLASTIC REFERENCES CHARACTER REFERENCES 1. A transcript of prior grades 2. A copy of SAT or ACT scores WITH THIS APPLICATION PLEASE ATTACH: 3. Your composition from the essay section of this application CHRISTOPHER COLUMBUS SCHOLARSHIP FUND, INC. I, (print), a high school senior and a resident of York County, hereby acknowledge that I may be awarded a Christopher Columbus scholarship. If I am awarded this scholarship, it is my understanding and I fully accept all responsibilities associated with receipt thereof. I understand that I may be called to appear before a scholarship committee for a personal interview. I further un derstand that all monies received will be in the form of a check which must be signed both by myself and the registrar of the school to which I plan on attending. This scholarship is good only for the coming school year. If the monies are not used, all mon ies will be returned to the Christopher Columbus Scholarship Fund. Signature of applicant: Date: Signature of parent or guardian (if applicable): Date: 5