Application Form

SCOTT SCRIBES SCHOLARSHIP: THE BESS WHITEHEAD SCOTT SCHOLARSHIP FOR OLDER ADULTS

IMPORTANT: COMPLETED APPLICATION MUST BE POSTMARKED BY APRIL 2, 2004, AND YOU MUST BE 40 OR OLDER ON THAT DATE

Name (first, middle, last)
Home Address (Street #, City, Zip Code)
Business Address (Street #, City, Zip Code)
Home Phone
Business Phone
e-mail Address
If Attending or Planning to Attend College, Give Name of Institution.
Highest Education Completed.
Birth Date:
(must be 40 or older on 4/02/04)
Social Security Number
  1. In about 100 words, describe your long-term goals and how this scholarship can help you attain them. Please attach another sheet with your answers to Questions 1-4.
  2. In about 100 words, describe your life's main accomplishments including academic, professional and community activities. Please attach another sheet with your answers to Questions 1-4.
  3. In about 100 words, state the objectives of your educational program and list your course of study. Please attach another sheet with your answers to Nos. 1-4.
  4. Please state what percentage of your education is financed by a) Scholarships, b) Loans, c) Jobs, d) Family, e) Other (please specify). Please attach another sheet with your answers to Questions 1-4.
  5. Please provide a short writing sample, either published or unpublished.
  6. If attending college, what is your grade point average?
  7. Please attach your resume, including personal references.

Your signature _____________________________________________________

Date _____________________

The $1,000 Scott Scribes Scholarship is administered by the Writers' League of Texas, a nonprofit group founded in 1981 that provides services and events for its membership of 1,500 writers. Elaine Davenport chairs the Fund.