WILLIAM S. O'BRIEN MASONIC SCHOLARSHIP

Sponsored by
SUNCOAST MASTERS & WARDENS ASSOCIATION
A not-for-profit organization serving Masonic Lodges in the
20th & 21st Masonic Districts of Florida.
Click HERE to visit the Association's web site.

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2008 SCHOLARSHIP APPLICATION FORM

I would like to apply for the William S. O'Brien Masonic Scholarship under the following terms:

I understand High School seniors and graduates from Pinellas County and West Pasco County planning to pursue an education at an accredited two or four-year college, university, or technical trade school are eligible to apply without regard to race, color, sex, creed, religious preference, or Masonic affiliation. Only one scholarship will be awarded per year to a qualified candidate for the amount of no less than $1,000. The Scholarship Committee of the SunCoast Masters & Wardens Association will review applications, interview suitable candidates, and award the scholarship to that person who demonstrates scholastic achievement, coupled with volunteer service to the community. All decisions by the committee are final.

I further understand payment of the scholarship shall be made directly to the institution upon receipt of notification from the applicable institution that the recipient is enrolled therein. Should, for some reason, the winner not be able to receive the money (e.g., failing to enroll with a suitable educational institution within six months of announcement of the winner, or moves and cannot be located, etc.), the runner-up shall receive the scholarship.

I further understand all data gathered from this form will be verified by the Association in conjunction with the administration of my High School, and that it will not be published or made publicly available (other than to announce the winner); that the SunCoast Masters & Wardens Association will only use it to determine eligibility and qualifications for the Association's Scholarship.

THE DEADLINE FOR RECEIVING APPLICATIONS IS APRIL 15, 2008

WILLIAM S. O'BRIEN The Association's Scholarship is named after William (Bill) S. O'Brien who founded the Scholarship Committee and fund to help local students. W:.Bill was a Past Master of Gulf Beach Lodge No. 291 F.& A.M. in Madiera Beach (1991) but was devoted to supporting students throughout the Tampa Bay area, not just in his hometown, and championed the Association's Scholarship Committee for a number of years. Regretably, Bill passed away in December 2003. His enthusiasm and guidance is greatly missed by all.

Past Recipients
2007	Jesse Garrett O’Shea	Palm Harbor University High School
2006	Ryan Joseph Mills	Palm Harbor University High School
2005	Sarah Julian Donnini	Seminole High School
2004	Thanh Dieu Thi Doan	Gulf High School
2003	Nicole-Alexandria Lagtapon Guevara	Dunedin High School
2002	Joshua Mark Trulock	Palm Harbor University High School
2001	Amanda O'Sullivan	Clearwater High School

ADDITIONAL SCHOLARSHIPS

Gulf Beach Lodge No. 291 F.&A.M. has a $2,000.00 scholarship available. Please link to their website and choose Scholarship.

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FIELD VALIDATION: Specific rules for data entry have been incorporated into this web page. For example, some fields will be automatically "UPSHIFTED" or "downshifted" for you; other fields allow only numerics; others allow only alpha-numeric characters; also, please aviod using the pound symbol (#) - this will cause errors.

First Name	Middle Name	Last Name	Extension (Jr., III)
Resident Address
City	Zip Code

Telephone - include area code

E-Mail

Mother's/Guardian's Name	Daytime Telephone	Occupation
Mother's Company	Located at

Father's/Guardian's Name	Daytime Telephone	Occupation
Father's Company	Located at

High School

Main Telephone Number

Sex		Date of Birth (MM/DD/YYYY)
Male Female
Grade Point Average	No. of Years Attended this School

Number of siblings living at Home (include ages)

Number of siblings attending College (include ages)

Your Guidance Counselor's Name	Telephone	E-Mail Address
School You are Planning to Attend	Location of School (city, state)	Planned Field of Study

Explain reason for requesting scholarship

Have you ever been arrested, given a written warning, or taken into custody or accused, of a violation of law? (exclude parking or similar minor traffic violations)
Yes No

If Yes, give date, nature of incident and disposition:

Will you have a car at college?
Yes No

Manufacturer/Model

Year

Any accidents or traffic violations?
Yes No

If Yes, briefly describe:

Have you reason to expect scholarship aid from any other source?
Yes No
If so, give details:

Summarize your Volunteer Activities during your High School Years
Aviod inputting/pasting the pound symbol (#) - this will cause errors.

Clubs & Sports you participated in.
Aviod inputting/pasting the pound symbol (#) - this will cause errors.

Other Awards/Achievements you have won during High School.
Aviod inputting/pasting the pound symbol (#) - this will cause errors.

Other Comments or Questions (List siblings at home and their ages)
Aviod inputting/pasting the pound symbol (#) - this will cause errors.

Press Send to transmit your application. Press Clear to reset the form.

Thank you for your application and good luck!