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Scholarship Application
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Last
Address
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Daytime Telephone Number
*
Email
*
Are you an active member of MLTA?
*
Please make your selection
Yes
No
If no, what is your relationship to the active MLTA member?
Please make your selection
Spouse
Child/Stepchild
Grandchild
How are you related to an active member?
Spouse
Child/Step-Child
Grandchild
Name of MLTA Active Member and Organization
If you're not an active MLTA member – related Active Member's Name:
If you're not an active MLTA member – related Active Member's Employer:
What type of school will you be attending? (check all that apply):
*
Community College
University
Part-time
Full-time
2 yr Degree
4 yr Degree
Trade School
Name of School:
*
School Address:
*
Who/Where Should the funds be sent to at School? (i.e. Financial Aid Office, c/o Jane Doe)
*
Student ID#
*
What is/was your start date?
*
What is your projected completion date?
*
Area of Study/Degree – What do you want to study and why?
Organizations/Involvement – Please list community or school organizations you are active in, or have previously been active in. Please note leadership roles and dates.
*
Please tell us about your academic and/or career achievements:
*
Briefly explain your financial need:
*
Please attach an essay about why you think it is important to continue your education. This essay should include short and long term goals.
*
This essay should include short and long term goals. This essay should be 500 words or less. (PDF, DOC or DOCX)
Accepted file types: pdf, doc, docx, Max. file size: 2 GB.
Please upload Letter of reference 1 of 2.
*
These must be from someone in a position of authority such as:
Teacher
Councelor
School Administrator
Employer
Supervisor
Pastor
Accepted file types: pdf, doc, docx, Max. file size: 2 GB.
Please upload Letter of reference 2 of 2 (PDF, DOC, DOCX):
*
Accepted file types: pdf, doc, docx, Max. file size: 2 GB.
Statement of Accuracy
*
I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that my picture may be taken and used for any purpose deemed necessary to promote the Missouri Land Title Association. I hereby confirm my understanding that if chosen for an award, funds will not be disbursed until verification of enrollment in the school has been provided.
I understand that checking this box constitutes a signature confirming that I acknowledge and agree to the above terms and conditions.
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