Application 2015 (PDF)
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Author: Amy Bemis
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Brian Bemis Education Scholarship
Application
Name______________________________
High School___________________________
Address______________________________________________________________________________
Phone Number________________________________________________________________________
Email Address_________________________________________________________________________
Academics:
GPA:________________
Rank:________________
High School Academic Emphasis:__________________________________________________________
Future College or Secondary Education Plans:________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Prospective College Major or Future Career:_________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
School Involvement:
High School Activities:___________________________________________________________________
_____________________________________________________________________________________
Description of Involvement in High School Activities___________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Leadership Experience in Activities________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Community Involvement:
Community Activities:___________________________________________________________________
_____________________________________________________________________________________
Description of Involvement in Activities___________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Leadership Experience in Activities________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Contribution:
After completion of Secondary Education or College, how do you see yourself contributing to your
community? (Volunteer, Career, ext.)_____________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Automotive Industry:
Where do you see your future with regards to the auto industry (technician, body man, sales, finance,
marketing)
________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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Document ID: 0000215702.