Scholarship Assistance Form - Royal Arch Masons

Name of Applicant*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Age of Applicant*
Date of Birth*
Royal Arch Relationship*
- I am a Royal Arch Mason
- My Spouse is or was a Royal Arch Mason
- My Father is or was a Royal Arch Mason
- My Grandfather is or was a Royal Arch Mason
Their Name*
First Last
Royal Arch Chapter Name*
Royal Arch Chapter Number*
Location of Chapter (Town, City, Village in NY)*
Have you received a Royal Arch Scholarship in the past?*
- Yes
- No

References
If you have NOT RECEIVED A Royal Arch Scholarship in the past you must attach three (3) written recommendations with the application: a) Two (2) of which should be from Instructors who have had supervision over and observation of the applicant's academic work during the past two years. b) The third may be someone who has known the Applicant well over a period of time, preferably a Mason. (Should not be a relative or family member!)
Upload Reference Letters*
Drop files here or

Accepted file types: jpg, jpeg, pdf, Max. file size: 45 MB, Max. files: 6.
Can be one or multiple PDFs or scanned JPEGs
First Reference - Full Name*
First Reference - Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Second Reference - Full Name*
Second Reference - Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Third Reference - Full Name*
Third Reference - Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Household
Father's Name*
Father's Occupation*
Father's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mother's Name*
Mother's Occupation*
Mother's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Number of family members supported by family income*
Number (not including applicant) in college this coming year*
Your anticipated tuition and expenses for the coming school year*
Do you presently have any educational indebtedness?*
- Yes
- No
Indebtedness Amount
Current Student Status
I am*
- a senior in high school or have not matriculated to an institution of higher learning
- presently attending a College or other institution of higher learning
(Note: If APPLICANT has transferred from one College to another; verification of acceptance at new school, plus transcript of marks from former school must accompany this Application.)

Name of School*
School's Location*
School Official who may be contacted*
Contact Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Graduation (past or upcoming)*
Official High School Transcript*
Accepted file types: jpg, jpeg, pdf, Max. file size: 15 MB.
Can be a PDF or scanned JPEG
Grade Average*
Rank in Class*
Number of Students in Class*
Intended Field of Study*

Name of College or University*
College or University Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
In the Fall of 2022, I will be*
Major Field of Study*
Present Cumulative Quality Point Average*
Current Official College Transcript*
Accepted file types: pdf, jpg, jpeg, Max. file size: 25 MB.
(PDF or scanned JPEG)
Name of College / University Official who may be contacted*
First Last
Contact Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Essay Submission*
- I will paste the essay text here.
- I will upload the file (PDF, MS Word Doc)
All Applicants will write an essay of approximately 200 - 300 words describing their progress towards their individual career/educational goals and their financial needs. (Be as detailed as possible and do not use generalities.)
Paste Essay Here (will be converted to plain text)*
Upload Essay*
Accepted file types: doc, docx, pdf, Max. file size: 1 MB.
Veteran Consideration
- I am a qualifying Veteran
Please check this box if you are a Veteran and would like to be considered for a M/E/ Raymond Roche Royal Arch Veteran Scholarship. This scholarship is available to New York Royal Arch Veterans and the Veterans spouses of New York Royal Arch Masons. Your DD214 must be submitted with this application to be considered for the Veteran Scholarship.
Upload DD214 (PDF or scanned Jpeg)*
Accepted file types: pdf, jpg, jpeg, Max. file size: 25 MB.
Consent*
I agree.
The attached information is accurate and correct to the best of my knowledge and belief and is submitted to the ROYAL ARCH MASON SCHOLARSHIP AID COMMITTEE for their consideration in determining the merits of a Scholarship award. In submitting this application, I understand and agree to accept the decision of said Committee as final and conclusive.

Grand Chapter State of New York Royal Arch Masons