Emerald Scholarship Application

Last Name	First Name	M.I.	Home Phone

________________________________________________________________________

Mailing Address	City	State	Zip Code

Name of Parent(s) or Legal Guardian

I. EDUCATIONAL GOALS: (Write a personal essay of at least 300 words telling

about your career plans.)

II. List Community or volunteer service activities.

III. List special honors and awards that you have received, (i.e. Valedictorian, All-District, Regional Qualifier, State Qualifier, etc.).

IV. List the co-curricular and extra-curricular activities you participated in, (i.e. UIL, FFA, Basketball, Volleyball, etc.).

V. List work experience and summer activities.

VI. Any other information you feel would be beneficial to this application.

Roy and Jean Adams Memorial Scholarship Application

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2011-01-19

DCISD