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*
Email*
Age of Applicant*
Date of Birth*
Month
Day
Year
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)*
Month
Day
Year
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
This Fall, 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

Grand Chapter State of New York Royal Arch Masons