Giaûi Khuyeán Hoïc Nieân Khoùa (1997-1998)
(Ñôn Döï Tranh)



California ngaøy __________________________________________________________

Kính Göæ Hoäi Thaân Höõu Bình Thuaän:

Hoï vaø Teân:________________________________ Sinh ngaøy:____________________

Phuï Huynh Teân: _________________________________________________________

Ñiaï Chæ taïi: ______________________________ Thaønh Phoá:____________________

Tieåu Bang ___________________________ Ñieän Thoaïi:________________________

Hoïc Löïc: Lôùp_____________ Tröôøng:_________________________GPA: _________

Hoaëc: Naêm thöù nhaát - Phaân Khoa: __________________________________________

Ñaïi Hoïc:_________________________________________________ GPA: ____________

Phaàn Thöôûng (Awards):

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

4. _______________________________________________________________

Sinh Hoaït khaùc: Coäng Ñoàng, Theå Thao, Xaõ Hoäi, Y Teá ......

1.________________________________________________________________

2.________________________________________________________________

3.________________________________________________________________

Kính xin hoäi Thaân Höõu Bình Thuaän cho em ñöôïc ghi teân tham döï giaûi Khuyeán Hoïc Bình thuaän.


Laøm taïi:_________________________________Ngaøy:____________________________


Kyù Teân: _____________________Phuï Huynh Kyù Teân:__________________________

(Ñôn cho pheùp cuûa phuï huynh ñính keøm neáu öùng vieân döôùi 18 tuoåi)

BINHTHUAN FRIENDSHIP ASSOCIATION
P.O. Box 2504 . G14
Westminster, CA 92683 USA
Phone ( 714 ) 921-8066
SCHOLARSHIP AWARD APPLICATION
Applicant's Name ____________________ ________________________ ____________ Last First M.I. Address ___________________________________________________________________ Street __________________________________ _____________ _________________ City State Zip Code Phone (_____) _________________ Date of Birth __________ _________ ________ Area Code Number Month Day Year Parents' or Guardian's Name __________________________________________________ Current School : High School __________________________________________________ School name Grade level ______________________ GPA _____________ Must be senior to apply Or University __________________________________________________ School name Year __________________________ GPA _____________ Must be freshman to apply School Activities: *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ Community Activities: *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ Other Activities: *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ Awards: *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ Educational / Career Goals: *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ *________________________________________________________________________ Applicant's Signature_____________________________________ Date_______________ Parent's or Guardian's Signature ________________________________________________ Required if applicant is under 18 year old
Last Updated: Fri. Feb. 14 17:25 1997 PST

Sponsored ByAmpacT.net

Webmaster: Webmaster@AmPacT.net