KANSAS FUNERAL DIRECTORS ASSOCIATION FOUNDATION
SCHOLARSHIP APPLICATION
Name:_______________________________________________________________
Permanent
Address:____________________________________________________
(Include City, State and Zip Code)
Current Address (if
different):____________________________________________
(Include City, State and Zip Code)
HIGH SCHOOL EDUCATION
High School/City:_______________________________________________________
Years Attended:______________________ Year
Graduated:_____________________
COLLEGE EDUCATION
School
Graduation Date
Degree
GPA
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
MILITARY BACKGROUND (if any)
Branch
of Service:_______________________________________________________
Period of
Service:________________________ Rank Obtained:___________________
FUNERAL SERVICE EDUCATION
College you are
attending:_________________________________________________
Date your studies
commenced:______________________________________________
Anticipated graduation date:________________________________________________
WORK EXPERIENCE
Position:_______________________________________________________________________
______________________________________________________________________________
Employer:_______________________________________________________________________
_______________________________________________________________________________
Date of Employment:_______________________________________________________________
SCHOOL AND COMMUNITY ACTIVITIES
Activity:_______________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Dates of Participation:_____________________________________________________
____________________________________________________________________
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AVAILABLE FUNDS
Expected ea rnings
during school year
$__________________________
Aid from parents and /or
spouse
$__________________________
Loans
$__________________________
Other money available
$__________________________
How will tuition and /or
living expenses be paid other than scholarships?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
TO BE ANSWERED BY ALL:
Have you completed the following steps?
1. Answered all questions on the application? Yes
____
No_____
2. Registered properly with the Kansas State Board of
Mortuary Arts? Yes____
No____
REFERENCES
Name___________________________
Address______________________________
Phone number
_______________
Occupation
_________________________________
Name ___________________________
Address______________________________
Phone number _______________
Occupation
_________________________________
CERTIFICATION AND AGREEMENT
I certify that the above
information is true and can be verified by proper documentation, if
required. It is my intention to continue my mortuary science education
and to enter the field of funeral service in the state of Kansas upon
successful completion of professiona l
education, examination and
licensure.
I understand that if I receive a
scholarship award from the
KFDA Foundation, I will be required
to use it exclusively for tuition at the Mortuary Science School
indicated in this application. I unqualifiedly agree to use said award
for such tuition purposes. Further, 1 agree that should I fail to use
said award as required, I will repay in full said award to the
Foundation -within
90 days of receipt thereof with interest at the rate of ten percent
(10%) per annum thereon.
I certify the foregoing statements to
be true and correct to the best of my knowledge.
Date:________________________________________________________
Signature of
applicant:___________________________________________
Be sure to include academic transcripts, essay and
last year's
tax return.
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| Kansas Funeral Directors & Embalmers
Association, Inc. 1200 S. Kansas Ave.
P.O. Box 1904
Topeka, Kansas 66601-1904
785-232-7791
www.ksfda.org
kfda@kfda.kscoxmail.com |
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