APPLICATION FOR THE DUFF/CAPPS SCHOLARSHIP

Name

First Name

Last Name

Date of Birth

YYYY

Student's Email Address

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent or Guardian Name

First Name

Last Name

High School Attending

Activities

Please list any school, community and extra-curricular activities in which you participate.

Applications

Please list the college or universities to which you have applied.

Have you been accepted to one of these schools?

YES

If yes, which college or university do you plan to attend?

Church Involvement

Please describe your involvement in the church community of St. Michael's.

Impact

Please share the impact St. Michael's has had on you, your life and faith.

Today's Date

YYYY

Full Name

Please type your full name as signature.