ORACLE SET FOUNDATION, Inc.

SCHOLARSHIP APPLICATION FORM

SPRING 2004

STUDENT INFORMATION

Last Name: First Name: Middle Initial

SSN: Date of Birth: Resident of the District of Columbia? Yes No

Address: Street Number and Name

City State Zip

Home Phone: Email Address:

High School:

Guidance Counselor (Last name and first initial only):

Do you reside with: Both Parents One Parent Other

Which college do you plan to attend? Accepted? Yes No

What is your planned major area(s) of study?

Where will you live? Dorm Off-Campus At Home

Briefly describe your favorite activities and community service or volunteer work:  

 List your favorite activities:                               Community Service/Volunteer Work:

PARENT/GUARDIAN INFORMATION

FATHER:

Last Name: First Name: Middle Initial

Occupation/Title: Employer:

Highest Education Completed:

Did not complete high school High school graduate Associates Degree/Some college Bachelors Degree Graduate Degree, Masters, Ph.D. Select one

MOTHER:

Last Name: First Name: Middle Initial

Occupation/Title: Employer:

Highest Education Completed:

Did not complete high school High school graduate Associates Degree/Some college Bachelors Degree Graduate Degree, Masters, Ph.D. Select one

FINANCIAL INFORMATION

Gross annual income for parents/guardian: $0 - $25,000 $26,000 - $35,000 $36,000 - $45,000 $46,000 - $55,000 $56,000 - $65,000 $66,000 - $75,000 $76,000 or more Select one

How many members of your household will be attending school including your parents and yourself

Expected Family Contribution (EFC) from your Student Aid Report (SAR) (Ex. 4000)

ACADEMIC INFORMATION

Class Rank (If your school does not rank students leave the next two answers blank)

Number of students in your class: Your standing: Your GPA:

Please electronically sign here by typing your initials in the box