Legacy Scholarship Application

Section 1. Application Information

Name

Date

Permanent Address

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone

College/University Attending

Major

Classification

Section 2. Member Relative Information

Name of ATA Member

Club/Company/Employer

Address

Street Address Address Line 2 City State ZIP Code

Email

Relationship to Applicant

Parent
Grandparent
Living
Deceased

Member SInce

Current Classification

Section 3. Applicant’s Academic and Community Service History

List in chronological order high schools attended, then colleges. This information must be complete.

Applicant’s Academic and Community Service History

Name of Institution	Location (City, State)	Dates Attended	Grade Point Scale	Dates of Graduation

List any academic distinctions and honors you have received in high school or college

List school or college activities in which you have participated as well as any office you held in any of these organizations (athletics, clubs, school paper, fine arts, etc.)

List your activities outside school or college as well as any office you held in any of these organizations (clubs, organizations, community, etc.)

List employment you have held since entering high school

List any other scholarships awarded

Scholarship	Sponsor	Date	Amount

Do you qualify for in-state tutition

Yes
No

Please indicate name, relationship and ages of those you will be supporting:

Please give the names of your local community and school newspapers:

Section 4. Certification

I certify that the above information is true and correct to the best of my knowledge. A transcript of your grades must be submitted with this application.

Applicant's Signature

Date

Mail complete application to:

P.O. Box 70 Auburn, AL 36831 Phone: 334.821.3000 Fax: 334.821.3800 mailbox@alaturfgrass.org

Legacy Scholarship Guidelines