To be considered for a scholarship, the candidate must submit a completed application with the following information to the John P. Burke Memorial Fund by April 15th:

1. A transcript of secondary school record or transcripts from all college work since high school graduation.
2. A copy of the student’s Free Application for Federal Student Aid (FAFSA), Student Aid Report (SAR) and copy of the school's financial aid award letter.  If the school required the student to submit the CSS/PROFILE, a copy must also be provided.   NOTE: All applicable information must be submitted to be considered for a scholarship.
3. A copy of the family’s latest Income Tax Return.
4. A letter of recommendation from the high school principal or guidance counselor.
5. A letter of recommendation from an officer or board member of the club sponsoring the student.
6. A letter of recommendation from a member of the club sponsoring the student who knows the student.
7. A letter of recommendation from the Golf Professional, or Course Superintendent or House or General Manager of the club sponsoring the student.

The Selection Committee will review only completed applications with all required information, and will arrange interviews with the candidate.

Scholarships are awarded only for tuition, room, board and other costs billed by post secondary schools. Scholarship awards are for an academic year at any accredited post-secondary academic institution. The award is renewable for up to four (4) years. The student is required to maintain a minimum of a 2.0 GPA (4.0 System) to continue the scholarship, and must submit a grade transcript each semester.

Confidentiality: All information received by the John P. Burke Memorial Fund is held in strictest confidence and used solely for the selection of scholarship recipients.

Prospective candidates for a scholarship will receive consideration without discrimination because of race, creed, color, sex, age, national origin or handicap.

Deadline for receiving completed application and the requested forms and information is April 15th.

I hereby apply to the John P. Burke Memorial Fund for scholarship assistance.

PLEASE PRINT OR TYPE

Name ___________________________________________________________________________________

FIRST MIDDLE LAST

Address ___________________________________________________________________­­­____________

NUMBER & STREET CITY & STATE ZIP

Telephone Number ____________________________ Date of Birth ___________________________

Email Address ________________________ Number Living at Home ___________________

Number of Children in Family ____________ Number of Children (other than applicant) in College________

Father’s Or Guardian’s Name _________________________________________________________________

Father’s Occupation ________________________________________________________________________

Mother’s Or Guardian’s Name ________________________________________________________________

Mother’s Occupation _______________________________________________________________________

Parent’s Own Home? ______ Estimated Value ______________ Amount Owed ____________________

Rent Home? _____ Monthly Rent ____________

Number Cars? ______ Make(s) & Year(s) _______________________________________________________

Sponsoring Club(s) _________________________________________________________________________

Position Worked ____________________________________________ Number of Years Worked __________

High School Attending: _______________________________________________________________________

College Attending, If applicable _____________________________________ Graduation Year ____________

Have you ever enrolled in another college? (name) ____________________________ When?_______________

Were you ever dismissed from a school? _________ Name of School _________________________________

Reasons for dismissal _______________________________________________________________________

Were you ever placed on probation? ____________ Name of School _________________________________

Reasons for probation ______________________________________________________________________

Scholastic Aptitude Tests Scores: Verbal ______________ Math _____________Essay ________________

Other Scores (AP, etc.) ____________________________________________________________________

Class Rank ______________________ Size of Class _______________________

I have applied to the following college(s):

College Accepted? Estimated Costs Financial Aid Received

1. ____________________________________________________________________________________________

2. ____________________________________________________________________________________________

3. ____________________________________________________________________________________________

4. _____________________________________________________________________________________________

Have you applied for other scholarship and aid? ______________

To what organization(s): ________________________________________ Amount Awarded:___________

________________________________________ ___________

________________________________________ ___________

What profession do you intend to follow?

1. ____________________________________________________________________________________________

2. ____________________________________________________________________________________________

3. ____________________________________________________________________________________________

What special recognition have you received for excellence in school work, such as honors, prizes, scholarships?

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

What fields of study interest you most?

_____________________________________________________________________________________________

_____________________________________________________________________________________________

List community or other organizations not connected with your school in which you have been active, and indicate those in which you have held responsible positions:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

List activities in which you have taken part, such as representing your school in academic and athletic interscholastic contests, editorships, entertainments and holding responsible offices in students’ organizations and responsible positions in school functions. Comment on any special recognition you have received.

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Indicate your hobby, if you have one.

_____________________________________________________________________________________________

In what ways have you contributed toward your financial support while in high school or college ?

Will you seek employment to contribute toward your financial support :

1) while in college? _________________________________________________________________________

2) during the summer? ______________________________________________________________________

Estimated Summer Earnings _______________________ Your Bank Savings _________________________

A VOLUNTARY SUBMISSION OF A PHOTOGRAPH WOULD BE APPRECIATED.

By signing below, we certify that the information in this application is accurate and complete to the best of our knowledge and belief.

Applicant’s Signature _______________________________________________ Date ________________

Parent/Guardian Signature ___________________________________________ Date ________________

Deadline Date for Submission for Completed Application, Requested Forms and Information is April 15th.

Mail to: