Sam Potter Memorial Scholarship ApplicationSam Potter Memorial Scholarship Application Please complete this scholarship form, compile the necessary paperwork requested and submit by March 10th. Late applications will not be accepted.Please provide two letters of recommendations and a transcript through the first semester of your senior year. Make sure that your transcript includes both your class rank and your ACT scores. Note: At the end of this application is your chance to help us understand why your need is for this scholarship. Name * Age * Parent or Guardian * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Number of dependent children in the family * Number of dependent children in post high school programs * Have you enrolled in a post high school program * YesNo If Yes, Where ServicesList the services that you have provided to your school, church, community or other charitable areas. Service * plus1 Add minus1 RemoveLeadershipList the different ways that you have provided leadership throughout your high school years. Don’t just limit it to the school but also include the community or other organizations you belong to. Leadership * plus1 Add minus1 Remove In a short paragraph or two explain why your need for financial assistance is greater than most high school seniors. Please be as specific as possible. * Please attach your transcript and and other documents Drop a file here or click to upload Choose FileMaximum file size: 157.29MB Submit