Buford Masonic Lodge No. 292 Scholarship Application Form

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Applicant's Name

First

Last

Applicant's Phone Number

Parent's Phone Number

Applicant's Email

Confirm Email

Applicant's Street Address

Applicant's City, State and Zip

Parent or Legal Guardians Name

Parent or Legal Guardian's Email

Confirm Email

Freemasons, Past or Present, Known by Applicant’s Family. Include their Lodge Name/Number if Known:

Enter “None” if none known

List your siblings; Include Name, Age, Grade Level, School Attending:

Enter “None” if you have no siblings

University or School Applicant Will Attend

Course of Study:

Major:

Career Applicant Expects to Pursue After Graduation, and Briefly Explain Why Applicant Chose This Career:

SAT Verbal Score:

SAT Math Score:

Offiical High School Grade Point Average

Selected Value: 0

School and Extracurricular Activites Applicant Has Participated In. i.e., Sport, Scholastic, Leadership, Community Service etc.:

Please List or Attach Your Community Service Record. Please Include Description, Hours, Location, Contact Person, and Contact Number/Email

Awards and Achievements:

Please List Any Academic or Community Honors, Special Recognitions, or Achievements

Scholarships Applicant Has Been Rewarded:

Upload Files:

Click or drag files to this area to upload. You can upload up to 10 files.

Submission Checklist

I have included at least one letter of recommendation from a Dacula High School teacher
I have included at least one letter of recommendation from a Community Leader

Personal Confirmation:

By checking this box, I confirm all submiited data and forms are accurate and truthful. I also acknowledge that any false submission will automatically disqualify me from this scholarship.