2008 WSALC
SCHOLARSHIP APPLICATION
Fill out and postmark by April 1, 2008 to:
WSALC SCHOLARSHIP COMMITTEE
c/o Eric Pardick 2007 Committee Chair
17062 N Atlas Rd
Rathdrum, ID 83858
(Must be received by April 5, 2008)
PLEASE PRINT CLEARLY
Please accept my application for a WSALC Scholarship. I am a senior in the school year of 2006-2007, or a high school graduate. Year of graduation _______
I am the: son___daughter___ dependent of___ (please circle)
Active___Retired ___Deceased ___(please circle)
Letter Carrier (Name) ____________________________________________
of NALC Branch # _______ City ___________________________State ____
My name: ________________________________________________________
My home address: _________________________
City, State, Zip: ___________________________
* * * * * * * * *
This is to certify that all rules and regulations are understood and agreed to in the submission of this application.
________________________________ Date _________
(Signature of WSALC Member parent, or spouse (if deceased)
* * * * * * * * *
This is to certify that the above named WSALC parent is/was a Member in good standing in NALC Branch # ________.
________________________________ Date __________
(Signature of Branch President or Secretary)
* * * * * * * * *
I certify that the foregoing information is correct to the best of my knowledge and that I have included all required items with this application.
_________________________________________ Date _______________
(Signature of Applicant)