TO THE APPLICANT:

Please complete this application so we can determine your eligibility for receiving funds set aside to help students who plan to go on to post-secondary education and who satisfy other criteria developed by Citizens' Scholarship Foundation of America, Inc. (CSFA)

Complete your sections of this application at your earliest convenience; then forward the application to the person you have selected to complete the appraisal (page 4). You are encouraged to select a school or college counselor or teacher. If this procedure is inappropriate, you may select an employer, member of the clergy, a job supervisor, or any other person who is in a position to evaluate you according to the criteria given.

If any questions are not applicable to your current situation, please attach an explanatory note referring to the questions by section. If more space is required for information on any items, you may attach additional information. Please indicate appropriate sections.

You are responsible for seeing that all supporting document are submitted. CSFA and its affiliate programs reserve the right to process only applications found to be complete as of the application postmark deadline. Anything submitted becomes the report of J-E Dollars for Scholars and may be used for publicity purposes unless other wise indicated.

REMEMBER: This application becomes valid only when all completed sections have been submitted.