Christian Character and Leadership Scholarship

First Name:

Middle Name:

Last Name:

Address:

City:

State:

Zip:

 E-mail:

Phone:

Graduation Year:

 List leadership Activities:

 List Activities that
demonstrate Christian Character:

Name of High School:

 Address of High School:

 City:

 State:

 Zip:

 Name of Guidance Counselor:

 Guidance Counselor E-mail: